Dietary intake and urinary excretion of phytoestrogens in relation to cancer and cardiovascular disease

dc.contributor.advisorZollinger, Terrell
dc.contributor.authorReger, Michael Kent
dc.contributor.otherJones, Josette F.
dc.contributor.otherLiu, Ziyue
dc.contributor.otherZhang, Jianjun
dc.date.accessioned2015-03-31T16:30:25Z
dc.date.available2015-03-31T16:30:25Z
dc.date.issued2014
dc.degree.date2014en_US
dc.degree.grantorIndiana Universityen_US
dc.degree.levelPh.D.en_US
dc.descriptionIndiana University-Purdue University Indianapolis (IUPUI)en_US
dc.description.abstractPhytoestrogens that abound in soy products, legumes, and chickpeas can induce biologic responses in animals and humans due to structural similarity to 17β-estradiol. Although experimental studies suggest that phytoestrogen intake may alter the risk of cancer and cardiovascular disease, few epidemiologic studies have investigated this research question. This dissertation investigated the associations of intake of total and individual phytoestrogens and their urinary biomarkers with these chronic conditions using data previously collected from two US national cohort studies (NHANES and PLCO). Utilizing NHANES data with urinary phytoestrogen concentrations and follow-up mortality, Cox proportional hazards regression (HR; 95% CI) were performed to evaluate the association between total cancer, cardiovascular disease, and all-cause mortality and urinary phytoestrogens. After adjustment for confounders, it was found that higher concentrations of lignans were associated with a reduced risk of death from cardiovascular disease (0.48; 0.24-0.97), whereas higher concentrations of isoflavones (2.14; 1.03-4.47) and daidzein (2.05; 1.02-4.11) were associated with an increased risk. A reduction in all-cause mortality was observed for elevated concentrations of lignans (0.65; 0.43-0.96) and enterolactone (0.65; 0.44-0.97). Utilizing PLCO data and dietary phytoestrogens, Cox proportional hazards regression examined the associations between dietary phytoestrogens and the risk of prostate cancer incidence. After adjustment for confounders, a positive association was found between dietary intake of isoflavones (1.58; 1.11-2.24), genistein (1.42; 1.02-1.98), daidzein (1.62; 1.13-2.32), and glycitein (1.53; 1.09-2.15) and the risk of advanced prostate cancer. Conversely, an inverse association existed between dietary intake of genistein and the risk of non-advanced prostate cancer (0.88; 0.78-0.99) and total prostate cancer (0.90; 0.81-1.00). C-reactive protein (CRP) concentration levels rise in response to inflammation and higher levels are a risk factor for some cancers and cardiovascular disease reported in epidemiologic studies. Logistic regression performed on NHANES data evaluated the association between CRP and urinary phytoestrogen concentrations. Higher concentrations of total and individual phytoestrogens were associated with lower concentrations of CRP. In summary, dietary intake of some phytoestrogens significantly modulates prostate cancer risk and cardiovascular disease mortality. It is possible that these associations may be in part mediated through the influence of phytoestrogen intake on circulating levels of C-reactive protein.en_US
dc.identifier.urihttps://hdl.handle.net/1805/6053
dc.identifier.urihttp://dx.doi.org/10.7912/C2/2823
dc.language.isoen_USen_US
dc.subjectEpidemiologyen_US
dc.subjectPhytoestrogensen_US
dc.subjectNutritionen_US
dc.subjectCanceren_US
dc.subjectCardiovascular Diseaseen_US
dc.subjectC-reactive proteinen_US
dc.subject.lcshEpidemiology -- Research -- Methodologyen_US
dc.subject.lcshEpidemiology -- Statistical methodsen_US
dc.subject.lcshCancer -- Epidemiologyen_US
dc.subject.lcshProstate -- Cancer -- Nutritional aspectsen_US
dc.subject.lcshPhytoestrogens -- Physiological effect -- Researchen_US
dc.subject.lcshPhytoestrogens -- Health aspectsen_US
dc.subject.lcshCardiovascular system -- Diseases -- Nutritional aspectsen_US
dc.subject.lcshCardiovascular system -- Diseases -- Alternative treatmenten_US
dc.subject.lcshIpriflavone -- Health aspects -- Physiological effect -- Researchen_US
dc.subject.lcshC-reactive protein -- Researchen_US
dc.subject.lcshNutrition -- Evaluation -- Researchen_US
dc.subject.lcshGenistein -- Researchen_US
dc.subject.lcshLogistic regression analysisen_US
dc.subject.lcshBiochemical markers -- Researchen_US
dc.subject.lcshLignans -- Researchen_US
dc.subject.lcshRegression analysisen_US
dc.subject.lcshSurvival analysis (Biometry)en_US
dc.titleDietary intake and urinary excretion of phytoestrogens in relation to cancer and cardiovascular diseaseen_US
dc.typeThesisen_US
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