Circulating enterolactone and risk of endometrial cancer

Zeleniuch‐Jacquotte, Anne; Lundin, Eva; Micheli, Andrea; Koenig, Karen L.; Lenner, Per; Muti, Paola; Shore, Roy E.; Johansson, Ingegerd; Krogh, Vittorio; Lukanova, Annekatrin; Stattin, Pär; Afanasyeva, Yelena; Rinaldi, Sabina; Arslan, Alan A.; Kaaks, Rudolf; Berrino, Franco; Hallmans, Göran; Toniolo, Paolo; Adlercreutz, Herman

doi:10.1002/ijc.22140

Cited by 24 publications

(10 citation statements)

References 33 publications

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“…The median enterolactone level measured in our study is in accordance with the range of previously published circulating enterolactone concentrations in the US and Europe [49,29,50,36,37,30,51,52,28,53,54,33,55], but lower than that in Asia [56]. We did not observe an association between plasma enterolactone, a biomarker of lignan intake, and breast cancer risk either overall or by hormone receptor status.…”

Section: Discussionsupporting

confidence: 91%

Plasma enterolactone and breast cancer risk in the Nurses’ Health Study II

Xie

Tworoger

Franke

et al. 2013

Breast Cancer Res Treat

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Background Lignans are plant-based phytoestrogens with both estrogenic and anti-estrogenic properties that may be important for breast carcinogenesis. Retrospective studies have observed decreased breast cancer risk associated with high circulating enterolactone concentrations, a biomarker of lignan intake, but results from prospective studies are conflicting. Methods To prospectively examine this association, we measured plasma enterolactone levels in 802 breast cancer cases and 802 matched controls nested among predominantly premenopausal women in the Nurses’ Health Study II (NHSII) cohort. We used conditional logistic regression and polytomous logistic regression models, adjusting for known breast cancer risk factors, to calculate relative risks (RR) and 95% confidence intervals (CI). Results Compared to women with enterolactone concentrations ≤ 4nmol/L, the multivariate adjusted RRs for breast cancer were 1.18 (95% CI: 0.86–1.62), 0.91 (95% CI: 0.66–1.25), and 0.96 (95% CI: 0.70–1.33) for women with enterolactone levels in the 2nd to the 4th quartiles, respectively; Ptrend=0.60. Results were similar across tumors defined by estrogen and progesterone receptor status. Among premenopausal women with follicular estradiol levels below the median (<47 pg/mL), women in the highest category of enterolactone levels had a 51% lower breast cancer risk compared to those in the lowest category (95% CI: 0.27–0.91); Ptrend=0.02. No association was observed among women with high follicular estradiol levels (≥47 pg/mL), (comparable RR=1.39, 95% CI: 0.73–2.65; Pinteraction=0.02). Conclusions We did not observe an overall association between plasma enterolactone and breast cancer risk in a large nested case-control study of US women. However, a significant inverse association was observed among premenopausal women with low follicular estradiol levels, suggesting that enterolactone may be important in a low estrogen environment. This should be confirmed in future studies.

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Section: Discussionsupporting

confidence: 91%

Plasma enterolactone and breast cancer risk in the Nurses’ Health Study II

Xie

Tworoger

Franke

et al. 2013

Breast Cancer Res Treat

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“…To our knowledge, only three case-control studies [9–11] have reported on the role of phytoestrogens on endometrial cancer risk, with conflicting results. A few additional studies examining the impact of soy foods, the main source of isoflavones, tended to suggest an inverse association [10, 12].…”

Section: Introductionmentioning

confidence: 99%

Phytoestrogen consumption and endometrial cancer risk: a population-based case–control study in New Jersey

Bandera

Williams

Sima

et al. 2009

Cancer Causes Control

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Phytoestrogens have been shown to exert anti-estrogenic and estrogenic effects in some tissues, including the breast. However, only a few studies have evaluated their role in endometrial cancer risk. We evaluated this association in a population-based case-control study in New Jersey. A total of 424 cases and 398 controls completed an interview, including a food frequency questionnaire with supplemental questions for phytoestrogen foods. Risk estimates were derived using unconditional logistic regression, adjusting for major risk factors for endometrial cancer. There was some suggestion of a decreased risk with quercetin intake (OR: 0.65; 95% CI: 0.41-1.01 for the highest compared to the lowest quartile; p for trend: 0.02). We found limited evidence of an association with any of the lignans evaluated, total lignans, coumestrol, individual isoflavones, total isoflavones, or total phytoestrogens. However, there was some suggestion of an inverse association with total isoflavone intake limited to lean women (BMI <25) (OR for the highest tertile: 0.50, 95% CI: 0.25-0.98) and those with a waist-to-hip ratio ≤0.85 (OR: 0.59; 95% CI: 0.33-1.05). There was no evidence of effect modification by HRT use. This study suggests a reduction in endometrial cancer risk with quercetin intake and with isoflavone intake in lean women.

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“…The main dietary precursors are identified as SECO, matairesinol and recently lariciresinol and pinoresinol (Milder et al, 2005b). As this transformation again was shown to be performed uniquely by bacteria (Bowey et al, 2003) and as the enterolignans would have increased biological activity (McCann et al, 2005;Kuijsten et al, 2006;Saarinen et al, 2006;Zeleniuch-Jacquotte et al, 2006), it can be concluded that intestinal bacteria also determine health effects related to lignan intake.…”

Section: Bioavailability Of Phyto-oestrogens: the Role Of Intestinal mentioning

confidence: 99%

“…, 2006; Saarinen et al. , 2006; Zeleniuch‐Jacquotte et al. , 2006), it can be concluded that intestinal bacteria also determine health effects related to lignan intake.…”

Section: Bioavailability Of Phyto‐oestrogens: the Role Of Intestinal mentioning

confidence: 99%

Oestrogenicity of prenylflavonoids from hops: activation of pro‐oestrogens by intestinal bacteria

Possemiers¹,

Verstraete

2009

Environ Microbiol Rep

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For many centuries, hops (Humulus lupulus L.) have been used as essential ingredient in beers, providing the typical bitterness and hoppy flavour. However, the last few years the plant has gained increasing attention as a source of prenylflavonoids and in 1999, 8-prenylnaringenin (8-PN) was identified as the most potent phyto-oestrogen known so far. Hop extracts are therefore now marketed to reduce menopausal complaints. However, 8-PN concentrations in hops are very low, and variable efficiency of these extracts was observed. Yet, hops also contain isoxanthohumol (IX) in much higher amounts (IX/8-PN ratio in hop extracts is typically 10-20). This article reviews our recent findings on how the human intestinal microbiota may activate IX. Depending on inter-individual differences in the intestinal transformation potential, this conversion could easily increase the 8-PN exposure 10-fold. The variability in efficacy of hop extracts may therefore be explained by variable intestinal metabolism. Based on this scientific knowledge, an innovative strategy was developed to decrease this variability. First, Eubacterium limosum, capable of rapidly metabolizing all IX into 8-PN, was isolated from the complex intestinal ecosystem. This bacterium was then used to develop a new generation of hop products with increased reliability in effect. This strategy involves the use of the bacterium as probiotic, in which the bacterium is administered in combination with the original hop extract. This leads to efficient intestinal 8-PN production, also in individuals who originally did not harbour the appropriate bacteria. The findings presented in this review can therefore be considered as a typical example that good insight in the specific metabolic potential of complex microbial communities and individual bacterial species may offer important opportunities for the management and modulation of the microbial organization towards a certain metabolic function.

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Circulating enterolactone and risk of endometrial cancer

Cited by 24 publications

References 33 publications

Plasma enterolactone and breast cancer risk in the Nurses’ Health Study II

Plasma enterolactone and breast cancer risk in the Nurses’ Health Study II

Phytoestrogen consumption and endometrial cancer risk: a population-based case–control study in New Jersey

Oestrogenicity of prenylflavonoids from hops: activation of pro‐oestrogens by intestinal bacteria

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