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摘要
Background: Many studies have examined associations between dietary isoflavones and atherosclerosis, but few used objective biomarkers. @@@ Objectives: We examined the associations of isoflavone biomarkers (primary analyses) and equol production (secondary analyses) with the progression of carotid intima-media thickness (cIMT), and whether inflammation, systolic blood pressure (SBP), blood lipids, and sex hormone-binding globulin (SHBG) mediated these associations, in Chinese adults. @@@ Methods: This 8.8-y prospective study included 2572 subjects (40-75 y old) from the GNHS (Guangzhou Nutrition and Health Study; 2008-2019). The concentrations of daidzein, genistein, and equol were assayed by an HPLC-tandem MS in scrum (n = 2572) at baseline and in urine (n = 2220) at 3-y intervals. The cIMT of the common carotid artery (CCA) and bifurcation segment were measured by B-mode ultrasound every 3 y, and the progressions of cIMT (Delta cIMT) were estimated using the regression method. @@@ Results: Multivariable linear mixed-effects models (LMEMs) and ANCOVA revealed that subjects with higher serum isoflavones tended to have lower increases of CCA-cIMT. The mean +/- SEM differences in 8.8-y Delta CCA-cIMT between extreme tertiles of serum isoflavones were -17.1 +/- 8.4, -20.6 +/- 8.3, and -23.3 +/- 10.4 mu m for daidzein, total isoflavone, and equol (P-trends < 0.05), respectively. LMEMs showed that the estimated yearly changes (95% CIs) (mu m/y) in CCA-IMT were -2.0 (-3.8, -0.3). -1.9 (-3.6. -0.1). and -2.1 (-3.8, -0.3) in the highest (compared with the lowest) tertile of daidzein, genistein, and total isoflavones, respectively (P-interaction < 0.05). Path analyses indicated that the serum equol-atherosclerosis association was mediated by increased SHBG and decreased SBP. Similar beneficial associations were observed in the secondary analyses. @@@ Conclusions: Serum isoflavones and equol exposure were associated with reduced cIMT progression, mediated by SHBG and SBP.
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单位南方医科大学; 中山大学
