Danish Cancer Society Research Center, Unit of Diet, Genes and Environment, Strandboulevarden 49, 2100 Copenhagen, Denmark.
Department of Animal Science, Aarhus University, AU-Foulum, Blickers Alle 20, P.O. Box 50, 8830 Tjele, Denmark.
Br J Nutr. 2019 Sep 14;122(5):552-563. doi: 10.1017/S0007114518002143. Epub 2018 Sep 3.
The association between lifestyle and survival after colorectal cancer has received limited attention. The female sex hormone, oestrogen, has been associated with lower colorectal cancer risk and mortality after colorectal cancer. Phyto-oestrogens are plant compounds with structure similar to oestrogen, and the main sources in Western populations are plant lignans. We investigated the association between the main lignan metabolite, enterolactone and survival after colorectal cancer among participants in the Danish Diet, Cancer and Health cohort. Prediagnosis plasma samples and lifestyle data, and clinical data from time of diagnosis from 416 women and 537 men diagnosed with colorectal cancer were used. Enterolactone was measured in plasma using a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. Participants were followed from date of diagnosis until death or end of follow-up. During this time, 210 women and 325 men died (170 women and 215 men died due to colorectal cancer). The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95 % CI. Enterolactone concentrations were associated with lower colorectal cancer-specific mortality among women (HRper doubling: 0·88, 95 % CI 0·80, 0·97, P=0·0123). For men, on the contrary, enterolactone concentrations were associated with higher colorectal cancer-specific mortality (HRper doubling: 1·10, 95 % CI 1·01, 1·21, P=0·0379). The use of antibiotics affects enterolactone production, and the associations between higher enterolactone and lower colorectal cancer-specific mortality were more pronounced among women who did not use antibiotics (analysis on a subset). Our results suggest that enterolactone is associated with lower risk of mortality among women, but the opposite association was found among men.
生活方式与结直肠癌患者生存之间的关系尚未引起广泛关注。女性性激素雌激素与结直肠癌风险降低和结直肠癌患者死亡率降低有关。植物雌激素是结构与雌激素相似的植物化合物，西方人群的主要来源是植物木脂素。我们研究了主要木脂素代谢物肠内酯与丹麦饮食、癌症和健康队列中结直肠癌患者生存之间的关系。使用了 416 名女性和 537 名男性结直肠癌患者的诊断前血浆样本和生活方式数据以及诊断时的临床数据。使用液相色谱-串联质谱（LC-MS/MS）方法在血浆中测量肠内酯。从诊断之日起对参与者进行随访，直至死亡或随访结束。在此期间，210 名女性和 325 名男性死亡（170 名女性和 215 名男性死于结直肠癌）。使用 Cox 比例风险模型估计风险比（HR）和 95%CI。肠内酯浓度与女性结直肠癌特异性死亡率降低相关（每增加一倍的 HR：0.88，95%CI 0.80，0.97，P=0.0123）。相反，对于男性，肠内酯浓度与结直肠癌特异性死亡率升高相关（每增加一倍的 HR：1.10，95%CI 1.01，1.21，P=0.0379）。抗生素的使用会影响肠内酯的产生，而在未使用抗生素的女性中，肠内酯浓度与较低的结直肠癌特异性死亡率之间的相关性更为显著（亚组分析）。我们的结果表明，肠内酯与女性死亡率降低相关，但在男性中则发现了相反的关联。
