Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Diseases, West China Hospital, Sichuan University, Chengdu, China.
Laboratory of Pulmonary Immunology and Inflammation, Frontiers Science Center for Disease-related Molecular Network, Sichuan University, Chengdu, China.
BMJ Open Respir Res. 2024 Mar 5;11(1):e001708. doi: 10.1136/bmjresp-2023-001708.
The role of phytoestrogens in asthma/wheeze and lung function remains controversial. Thus, we aimed to examine whether phytoestrogens have beneficial effects on asthma/wheeze, lung function for subgroups and mortality.
Participants in this study were individuals aged 20 years or older from the National Health and Nutrition Examination Survey. Multivariate logistic regression models were fitted to examine the associations of urinary phytoestrogens with the risk of asthma/wheeze and lung function in individuals with and without asthma/wheeze. Cox proportional hazards regression was used to examine the relationship between urinary phytoestrogens and all-cause mortality. Stratified analyses were conducted based on gender and smoking status.
We included 2465 individuals in this study. Enterolactone levels in the highest quartile were associated with a lower risk of asthma than those in the lowest quartile. As compared with the lowest quartile, the highest quartile of enterodiol and enterolactone was associated with a lower risk of wheeze. Significant associations were observed between subtypes of phytoestrogens (equol and enterolactone) and lung function (forced vital capacity (FVC) and forced expiratory volume in 1 s). Besides, FVC was higher in individuals with higher levels of enterodiol. The results were consistent in subpopulations without asthma/wheeze, while the significant difference was not observed in individuals with asthma/wheeze. The stratified analyses revealed that the associations between phytoestrogens and lung function differed by gender and smoking status among subgroups. No significant association was found between urinary phytoestrogens and all-cause mortality.
In summary, subtypes of phytoestrogens were associated with lower risk of asthma/wheeze and beneficial for lung function improvement in individuals without asthma/wheeze. Furthermore, gender and smoking may interact in the relationship between phytoestrogens and asthma/wheeze, and lung function. Further researches are needed to confirm these associations and explain the results of stratified analyses.
植物雌激素在哮喘/喘息和肺功能中的作用仍存在争议。因此，我们旨在研究植物雌激素是否对哮喘/喘息、哮喘/喘息患者和非哮喘/喘息患者的肺功能具有有益影响。
本研究的参与者为来自全国健康和营养检查调查的 20 岁及以上的个体。采用多变量逻辑回归模型来研究尿植物雌激素与哮喘/喘息患者和非哮喘/喘息患者的哮喘/喘息风险和肺功能之间的关联。采用 Cox 比例风险回归来研究尿植物雌激素与全因死亡率之间的关系。基于性别和吸烟状况进行分层分析。
本研究共纳入 2465 名个体。与最低四分位相比，最高四分位的肠内酯水平与哮喘风险降低相关。与最低四分位相比，最高四分位的肠二醇和肠内酯与喘息风险降低相关。在植物雌激素（雌马酚和肠内酯）的亚型与肺功能（用力肺活量（FVC）和 1 秒用力呼气量）之间观察到显著关联。此外，肠二醇水平较高的个体的 FVC 较高。在无哮喘/喘息的亚群中，结果一致，但在有哮喘/喘息的个体中未观察到显著差异。分层分析表明，在亚组中，植物雌激素与肺功能之间的关联因性别和吸烟状况而异。尿植物雌激素与全因死亡率之间无显著关联。
综上所述，植物雌激素的亚型与无哮喘/喘息患者的哮喘/喘息风险降低和肺功能改善相关。此外，性别和吸烟可能会影响植物雌激素与哮喘/喘息和肺功能之间的关系。需要进一步的研究来证实这些关联，并解释分层分析的结果。
