Journal - American Journal of Epidemiology

Abstract :

The lignan enterolactone produced by the intestinal microflorafrom dietary precursors has been hypothesized to protect againstcoronary heart disease. The present study examined the associationbetween serum enterolactone concentration and the risk of coronaryheart disease. A prospective case-cohort study was conductedamong male smokers randomized to receive a placebo supplementin the Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study(1986–1999). Serum enterolactone concentrations were measuredby the gas chromatography-mass spectrometry method in serumcollected at trial baseline from 340 men diagnosed with nonfatalmyocardial infarction (n = 205) or coronary death (n = 135)during follow-up and from the randomly selected subcohort of420 subjects. The classic risk factors-adjusted rate ratiosfor all coronary heart disease events in increasing quintilesof enterolactone were 1.00 (referent), 0.85 (95% confidenceinterval (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 theptrend was 0.07. For the highest versus the lowest quintileof enterolactone, the rate ratios for nonfatal myocardial infarctionand 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 betweenserum enterolactone concentration and coronary heart diseasewas found.Abbreviations: ATBC, Alpha-Tocopherol, Beta-Carotene Cancer Prevention • CI, confidence interval • RR, rate ratio