Tsuchiya Masaki, Miura Tsutomu, Hanaoka Tomoyuki, Iwasaki Motoki, Sasaki Hiroshi, Tanaka Tadao, Nakao Hiroyuki, Katoh Takahiko, Ikenoue Tsuyomu, Kabuto Michinori, Tsugane Shoichiro
Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan.
Epidemiology. 2007 May;18(3):402-8. doi: 10.1097/01.ede.0000257571.01358.f9.
Progression of endometriosis is considered estrogen-dependent. Dietary soy isoflavones may affect the risk of endometriosis, and polymorphisms in estrogen receptor genes may modify this association. We examined associations among soy isoflavone intake, estrogen receptor 2 (ESR2) gene polymorphisms and risk of endometriosis.
We recruited women age 20-45 years old who had consulted a university hospital for infertility in Tokyo, Japan in 1999 or 2000. A total of 138 eligible women were diagnosed laparoscopically and classified into 3 subgroups: control (no endometriosis), early endometriosis (stage I-II) and advanced endometriosis (stage III-IV). We measured urinary levels of genistein and daidzein as markers for dietary intake of soy isoflavones, and genotyped ESR2 gene RsaI polymorphisms.
Higher levels of urinary genistein and daidzein were associated with decreased risk of advanced endometriosis (P for trend = 0.01 and 0.06, respectively) but not early endometriosis. For advanced endometriosis, the adjusted odds ratio for the highest quartile group was 0.21 (95% confidence interval = 0.06-0.76) for genistein and 0.29 (0.08-1.03) for daidzein, when compared with the lowest group. Inverse associations were also noted between urinary isoflavones and the severity of endometriosis (P for trend = 0.01 for genistein and 0.07 for daidzein). For advanced endometriosis, ESR2 gene RsaI polymorphism appeared to modify the effects of genistein (P for interaction = 0.03).
Dietary isoflavones may reduce the risk of endometriosis among Japanese women.
子宫内膜异位症的进展被认为依赖雌激素。膳食大豆异黄酮可能影响子宫内膜异位症的风险，并且雌激素受体基因的多态性可能改变这种关联。我们研究了大豆异黄酮摄入量、雌激素受体2（ESR2）基因多态性与子宫内膜异位症风险之间的关联。
我们招募了1999年或2000年在日本东京一家大学医院因不孕前来咨询的20 - 45岁女性。总共138名符合条件的女性通过腹腔镜检查进行诊断，并分为3个亚组：对照组（无子宫内膜异位症）、早期子宫内膜异位症（I - II期）和晚期子宫内膜异位症（III - IV期）。我们测量了尿中染料木黄酮和黄豆苷元水平作为膳食大豆异黄酮摄入量的标志物，并对ESR2基因RsaI多态性进行基因分型。
尿中染料木黄酮和黄豆苷元水平较高与晚期子宫内膜异位症风险降低相关（趋势P值分别为0.01和0.06），但与早期子宫内膜异位症无关。对于晚期子宫内膜异位症，与最低四分位数组相比，最高四分位数组染料木黄酮的调整优势比为0.21（95%置信区间 = 0.06 - 0.76），黄豆苷元为0.29（0.08 - 1.03）。尿异黄酮与子宫内膜异位症严重程度之间也存在负相关（染料木黄酮趋势P值为0.01，黄豆苷元为0.07）。对于晚期子宫内膜异位症，ESR2基因RsaI多态性似乎改变了染料木黄酮的作用（交互作用P值 = 0.03）。
膳食异黄酮可能降低日本女性患子宫内膜异位症的风险。
