The association between urinary genistein levels and mortality among adults in the United States.

Carolyn Marcelo,Catherine Marcelo,Melissa Warwick,Rehan Qayyum,Stephen L. Atkin

doi:10.1371/journal.pone.0211368

Carolyn Marcelo, Catherine Marcelo + Show 3 more

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https://doi.org/10.1371/journal.pone.0211368

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Journal: PloS one	Publication Date: Jan 25, 2019
Citations: 5	License type: CC BY 4.0

Affiliation: Virginia Commonwealth University Medical Center

Abstract

BackgroundCurrent research on the relationship between phytoestrogens and mortality has been inconclusive. We explored the relationship between genistein, a phytoestrogen, and mortality in a large cohort representative of the United States population.MethodsData were analyzed from the National Health and Nutrition Examination Survey (NHANES) from 1999–2010. Normalized urinary genistein (nUG) was analyzed as a log-transformed continuous variable and in quartiles. Mortality data were obtained from the National Death Index and matched to the NHANES participants. Survival analyses were conducted using the Kaplan-Meier analysis. Cox proportional hazard models were constructed for all-cause and cause-specific mortality without and with adjustment for potential confounding variables.ResultsOf 11,497 participants, 944 died during the 64,443 person-years follow-up. The all-cause mortality rate was significantly lower in the lowest quartile compared to the highest quartile (incidence rate ratio = 2.14, 95%CI = 1.76 to 2.60). Compared to the lowest quartile, the highest quartile had significantly higher adjusted all-cause (HR = 1.57, 95%CI = 1.23 to 2.00), cardiovascular (HR = 1.67, 95%CI = 1.04 to 2.68), and other-cause (HR = 1.85, 95%CI = 1.33 to 2.57) mortality.ConclusionWe found that high urinary genistein levels were associated with increased risk of all-cause, cardiovascular, and other-cause mortality. This is contrary to popular opinion on the health benefits of genistein and needs further research.

Highlights

Phytoestrogens are plant-based chemical compounds with structural similarities to female sex hormones such as 17-β-estradiol and diethylstilbestrol [1]
We found that high urinary genistein levels were associated with increased risk of all-cause, cardiovascular, and other-cause mortality
Survey weights were generated from the six 2-year cycles for the complete dataset so that the results are representative of the United States population

Summary

Introduction

Phytoestrogens are plant-based chemical compounds with structural similarities to female sex hormones such as 17-β-estradiol and diethylstilbestrol [1]. The most common phytoestrogens are isoflavones found in a variety of fruits and vegetables, soy products, legumes, and flax [2]. Several studies have suggested that phytoestrogens are associated with a lower risk of allcause mortality [3,4], cardiovascular disease mortality [3], and cancer mortality [5,6,7,8]. Other studies have found no benefit of phytoestrogen intake on all-cause, cardiovascular, or cancer mortality [9,10,11,12,13,14]. Some studies have found an increased mortality risk with phytoestrogen intake [15,16]. We explored the relationship between genistein, a phytoestrogen, and mortality in a large cohort representative of the United States population.

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Results

Conclusion