在既往无子宫肌瘤临床诊断的年轻非裔美国女性中，基于大豆的婴儿配方奶粉喂养与超声检测到的子宫肌瘤
Soy-Based Infant Formula Feeding and Ultrasound-Detected Uterine Fibroids among Young African-American Women with No Prior Clinical Diagnosis of Fibroids.
作者信息
Upson Kristen, Harmon Quaker E, Baird Donna D
机构信息
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
出版信息
Environ Health Perspect. 2016 Jun;124(6):769-75. doi: 10.1289/ehp.1510082. Epub 2015 Nov 13.
BACKGROUND
Early-life soy phytoestrogen exposure has been shown in Eker rats to increase uterine fibroid incidence in adulthood. Two large epidemiologic cohorts have provided some support for increased fibroid risk with infant soy formula feeding in women, but both cohorts relied on self-report of clinically diagnosed fibroids.
OBJECTIVE
We evaluated the relationship between infant soy formula feeding and ultrasound-detected fibroids.
METHODS
The Study of Environment, Lifestyle & Fibroids (SELF) is an ongoing cohort study of 1,696 African-American women ages 23-34 years with baseline ultrasound screening to detect and measure fibroids ≥ 0.5 cm in diameter. Questionnaire data on soy formula feeding during infancy was ascertained for 1,553 participants (89% based on mother's report), of whom 345 were found to have fibroids. We estimated the association between soy formula feeding and fibroid prevalence and tumor number using log-binomial regression. Among those with fibroids, we compared fibroid size between soy formula-exposed and unexposed women using multivariable linear regression.
RESULTS
We did not observe an association between soy formula feeding and fibroid prevalence [adjusted prevalence ratio (aPR) 0.9, 95% CI: 0.7, 1.3]. Nor were exposed women with fibroids more likely to have ≥ 2 tumors than unexposed women with fibroids (aPR 1.0, 95% CI: 0.7, 1.6). However, exposed women with fibroids had significantly larger fibroids than unexposed women with fibroids. On average, soy formula feeding was associated with a 32% increase in the diameter of the largest fibroid (95% CI: 6%, 65%) and a 127% increase in total tumor volume (95% CI: 12%, 358%).
CONCLUSIONS
Our observation that women fed soy formula as infants have larger fibroids than unexposed women provides further support for persistent effects of early life phytoestrogen exposure on the uterus.
CITATION
Upson K, Harmon QE, Baird DD. 2016. Soy-based infant formula feeding and ultrasound-detected uterine fibroids among young African-American women with no prior clinical diagnosis of fibroids. Environ Health Perspect 124:769-775; http://dx.doi.org/10.1289/ehp.1510082.
背景
在埃克大鼠中已表明，生命早期接触大豆植物雌激素会增加成年后患子宫肌瘤的几率。两项大型流行病学队列研究为女性因婴儿期食用大豆配方奶粉而增加患肌瘤风险提供了一些支持，但这两项队列研究均依赖于临床诊断肌瘤的自我报告。
目的
我们评估了婴儿期食用大豆配方奶粉与超声检测到的肌瘤之间的关系。
方法
环境、生活方式与肌瘤研究（SELF）是一项正在进行的队列研究，研究对象为1696名年龄在23 - 34岁的非裔美国女性，她们在基线时接受了超声筛查，以检测和测量直径≥0.5厘米的肌瘤。通过问卷调查获取了1553名参与者（基于母亲报告的比例为89%）婴儿期食用大豆配方奶粉的数据，其中345人被发现患有肌瘤。我们使用对数二项回归估计了食用大豆配方奶粉与肌瘤患病率及肿瘤数量之间的关联。在患有肌瘤的女性中，我们使用多变量线性回归比较了接触大豆配方奶粉和未接触大豆配方奶粉的女性之间的肌瘤大小。
结果
我们未观察到食用大豆配方奶粉与肌瘤患病率之间存在关联[调整患病率比（aPR）为0.9，95%置信区间：0.7，1.3]。接触大豆配方奶粉的患有肌瘤的女性也并不比未接触大豆配方奶粉的患有肌瘤的女性更有可能有≥2个肿瘤（aPR为1.0，95%置信区间：0.7，1.6）。然而，接触大豆配方奶粉的患有肌瘤的女性的肌瘤明显大于未接触大豆配方奶粉的患有肌瘤的女性。平均而言，食用大豆配方奶粉与最大肌瘤直径增加32%（95%置信区间：6%，65%）以及肿瘤总体积增加127%（95%置信区间：12%，358%）相关。
结论
我们观察到婴儿期食用大豆配方奶粉的女性比未接触大豆配方奶粉的女性肌瘤更大，这为生命早期接触植物雌激素对子宫的持续影响提供了进一步支持。
引用文献
厄普森K，哈蒙QE，贝尔德DD。2016年。在先前无肌瘤临床诊断的年轻非裔美国女性中，基于大豆的婴儿配方奶粉喂养与超声检测到的子宫肌瘤。《环境健康展望》124：769 - 775；http://dx.doi.org/10.1289/ehp.1510082 。
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