每日酒精摄入量对接受芳香化酶抑制剂治疗的绝经后乳腺癌幸存者性激素水平的影响：一项随机对照交叉试验性研究。
Effect of daily alcohol intake on sex hormone levels among postmenopausal breast cancer survivors on aromatase inhibitor therapy: a randomized controlled crossover pilot study.
作者信息
Mostofsky Elizabeth, Buring Julie E, Come Steven E, Tung Nadine M, Zhang Cancan, Mukamal Kenneth J
机构信息
Department of Epidemiology (EM, JEB) and Nutrition (KJM), Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Kresge 505-B, Boston, MA, 02115, USA.
Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
出版信息
Breast Cancer Res. 2025 Jan 9;27(1):5. doi: 10.1186/s13058-024-01940-4.
BACKGROUND
Alcohol intake is associated with a higher risk of estrogen receptor-positive (ER+) breast cancer (BC), presumably through its confirmed ability to increase sex hormone levels. Whether consuming alcohol within the recommended limit of one serving per day increases sex hormone levels among postmenopausal women taking aromatase inhibitors (AI) to inhibit estrogen production remains unknown. Therefore, we compared sex hormone levels following white wine to levels following white grape juice among ER + BC survivors taking AIs.
METHODS
In this 10-week randomized controlled two-period crossover trial conducted from September 2022 to July 2023 among 20 postmenopausal women on AIs, we examined within-person changes in sex hormone levels following 3 weeks of 5 ounces of white wine daily versus 3 weeks of 6 ounces of white grape juice daily, with each drinking period preceded by two-week washouts and drinking period sequence allocated by randomization.
RESULTS
All 20 participants completed the trial. Compared to daily grape juice, daily wine led to decreases in total estradiol (11.1%, 95%confidence interval[CI] -49.8%,57.2%), free estradiol index (0.7%, 95%CI -2%,0.7%), and free estradiol concentration (7.7%, 95%CI -48%, 63.9%) but increases in estrone (13.8%, 95%CI -9.5%,43.1%), dehydroepiandrosterone sulfate (DHEAS; 11.4%, 95%CI -3.3%,28.4%), and testosterone (12.6%, 95%CI -0.8%,27.7%) and decreased sex hormone-binding globulin (SHBG; -2.7%, 95%CI -21.9%,21.2%).
CONCLUSIONS
Five ounces of white wine daily did not lead to statistically significant increases in estradiol, but it led to changes in other sex hormones suggesting higher BC risk. Whether this level of alcohol intake diminishes AI effectiveness warrants further investigation.
TRIALS REGISTRATION
Clinicaltrials.gov NCT05423730 registered June 14, 2022.
背景
饮酒与雌激素受体阳性（ER+）乳腺癌（BC）风险较高相关，可能是因为其已被证实有提高性激素水平的能力。对于正在服用芳香化酶抑制剂（AI）以抑制雌激素生成的绝经后女性，每天饮用一份酒是否会提高性激素水平仍不清楚。因此，我们比较了正在服用AI的ER+ BC幸存者饮用白葡萄酒后与饮用白葡萄汁后的性激素水平。
方法
在2022年9月至2023年7月对20名正在服用AI的绝经后女性进行的这项为期10周的随机对照两期交叉试验中，我们研究了每天饮用5盎司白葡萄酒3周与每天饮用6盎司白葡萄汁3周后性激素水平的个体内变化，每个饮酒期之前有两周的洗脱期，饮酒期顺序通过随机分配。
结果
所有20名参与者均完成试验。与每日饮用葡萄汁相比，每日饮用葡萄酒导致总雌二醇水平下降（11.1%，95%置信区间[CI] -49.8%，57.2%）、游离雌二醇指数下降（0.7%，95%CI -2%，0.7%）、游离雌二醇浓度下降（7.7%，95%CI -48%，63.9%），但雌酮水平升高（13.8%，95%CI -9.5%，43.1%）、硫酸脱氢表雄酮（DHEAS）水平升高（11.4%，95%CI -3.3%，28.4%）、睾酮水平升高（12.6%，95%CI -0.8%，27.7%），且性激素结合球蛋白（SHBG）水平下降（-2.7%，95%CI -21.9%，21.2%）。
结论
每天饮用5盎司白葡萄酒并未导致雌二醇水平出现统计学上的显著升高，但导致了其他性激素变化，提示BC风险更高。这种饮酒量是否会降低AI的疗效值得进一步研究。
试验注册
Clinicaltrials.gov NCT05423730，于2022年6月14日注册。
Zotero 插件