American Journal of Epidemiology Advance Access originally published online on March 1, 2006
American Journal of Epidemiology 2006 163(8):687-693; doi:10.1093/aje/kwj080
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Original Contribution |
Serum Enterolactone Concentration and the Risk of Coronary Heart Disease in a Case-Cohort Study of Finnish Male Smokers
1 Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland
2 Department of Health and Functional Capacity, National Public Health Institute, Helsinki, Finland
3 Department for Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
Correspondence to Dr. Annamari Kilkkinen, Department of Epidemiology and Health Promotion, National Public Health Institute, Mannerheimintie 166, Helsinki 00300, Finland (e-mail: annamari.kilkkinen{at}ktl.fi).
The lignan enterolactone produced by the intestinal microflora from dietary precursors has been hypothesized to protect against coronary heart disease. The present study examined the association between serum enterolactone concentration and the risk of coronary heart disease. A prospective case-cohort study was conducted among male smokers randomized to receive a placebo supplement in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (1986–1999). Serum enterolactone concentrations were measured by the gas chromatography-mass spectrometry method in serum collected at trial baseline from 340 men diagnosed with nonfatal myocardial infarction (n = 205) or coronary death (n = 135) during follow-up and from the randomly selected subcohort of 420 subjects. The classic risk factors-adjusted rate ratios for all coronary heart disease events in increasing quintiles of enterolactone were 1.00 (referent), 0.85 (95% confidence interval (CI): 0.51, 1.43), 0.59 (95% CI: 0.35, 1.00), 0.69 (95% CI: 0.40, 1.16), and 0.63 (95% CI: 0.33, 1.11), and the ptrend was 0.07. For the highest versus the lowest quintile of enterolactone, the rate ratios for nonfatal myocardial infarction and coronary death were 0.67 (95% CI: 0.37, 1.23; ptrend = 0.10) and 0.57 (95% CI: 0.26, 1.25; ptrend = 0.18), respectively. In conclusion, only weak support for the association between serum enterolactone concentration and coronary heart disease was found.
biological markers; cardiovascular diseases; cohort studies; coronary disease; diet; myocardial infarction; prospective studies; serum
Abbreviations: ATBC, Alpha-Tocopherol, Beta-Carotene Cancer Prevention; CI, confidence interval; RR, rate ratio
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