膳食类黄酮摄入与激素相关癌症风险：一项基于人群的前瞻性队列研究

Dietary flavonoid intake and risk of hormone-related cancers: A population-based prospective cohort study

PHYTOMEDICINE

影响因子:8.3

分区:医学1区 Top / 药物化学1区全科医学与补充医学1区药学1区植物科学1区

发表日期:2024 Oct

作者: Fubin Liu, Jingyi Xu, Xixuan Wang, Yu Peng, Peng Wang, Changyu Si, Jianxiao Gong, Huijun Zhou, Ming Zhang, Liangkai Chen, Fangfang Song

DOI: 10.1016/j.phymed.2024.155950

摘要

由于具有调节激素、抑制炎症和氧化应激等抗癌特性，膳食类黄酮可能对激素相关癌症（HRCs）具有潜在影响。本研究旨在探讨黄酮摄入与HRCs风险的关系，以及血液生物标志物在其中的中介作用。本前瞻性队列研究来自英国生物库，纳入了187,350名在完成最后一次膳食回忆时未患癌症的参与者。通过24小时膳食回忆评估黄酮及其亚类的摄入量。在基线采集静脉血样，检测炎症、激素和氧化应激的生物标志物。采用原因特异性Cox比例风险模型估算黄酮摄入与HRCs风险的HR和95%置信区间（CI），并通过中介分析研究血液生物标志物在两者关系中的作用。在中位随访9.5年期间，记录了3392例女性乳腺癌、417例卵巢癌、516例子宫内膜癌、4305例前列腺癌、45例睾丸癌和146例甲状腺癌。与最低五分之一组相比，调校多变量后的最高五分之一组总黄酮摄入对应乳腺癌的HR为0.89（0.80-0.99）、卵巢癌为0.68（0.50-0.92）、女性特异性癌症为0.88（0.80-0.98）。亚类方面，黄酮醇和花青素的摄入与女性特异性癌症风险呈负相关（Ptrend <0.05）。花青素摄入与前列腺癌风险正相关，而异黄酮摄入则与甲状腺癌风险负相关（Ptrend <0.05）。此外，某些炎症、激素和氧化应激的生物标志物共同中介了黄酮摄入与女性特异性癌和前列腺癌风险的关系。我们的发现强调了膳食类黄酮在预防HRCs中的重要性，为膳食指南提供了流行病学依据。

Abstract

Dietary flavonoids may have potential effects on hormone-related cancers (HRCs) due to their anti-cancer properties via regulating hormones and suppressing inflammation and oxidative stress. We aimed to examine the association of flavonoid intake with risks of HRCs and whether this association was mediated by blood biomarkers involved in biological mechanisms.This prospective cohort study from UK Biobank included 187,350 participants free of cancer when the last dietary recall was completed. The dietary intakes of flavonoids and subclasses were assessed using 24-hour dietary recalls. Venous blood was collected at baseline and assayed for biomarkers of inflammation, hormones, and oxidative stress. Hazard ratios (HR) and 95 % confidential intervals (CI) for the associations between flavonoid intake and HRCs risk were estimated by the cause-specific Cox proportional hazards model. The role of blood biomarkers in the flavonoids-HRCs association was investigated through mediation analysis.Over a median follow-up of 9.5 years, 3,392 female breast cancer, 417 ovarian cancer, 516 endometrial cancer, 4,305 prostate cancer, 45 testicular cancer, and 146 thyroid cancer cases were documented. Compared to the lowest quintile, multivariable-adjusted HRs (95 % CIs) in the highest quintile of total flavonoid intake were 0.89 (0.80-0.99) for breast cancer, 0.68 (0.50-0.92) for ovarian cancer, and 0.88 (0.80-0.98) for female-specific cancers. For subclasses, intakes of flavonols and anthocyanidins were inversely associated with the risk of female-specific cancers (Ptrend <0.05). Anthocyanidin intake was positively related to prostate cancer risk, whereas isoflavone intake was inversely linked to thyroid cancer risk (Ptrend <0.05). Additionally, certain biomarkers of inflammation, hormones and oxidative stress jointly mediated the association of flavonoid intake with the risk of female-specific cancers and prostate cancer.Our findings highlighted the importance of dietary flavonoids for the prevention of HRCs in the general population, providing epidemiological evidence for dietary guidelines.