亚麻籽可预防女性尿失禁

奥兰多——美国马萨诸塞州总医院的Evgeniy I. Kreydin博士在美国泌尿外科学会年会 “优秀海报” 议会上报告了一项基于人群的大型、前瞻性队列研究，结果显示，木酚素类植物雌激素，并非异黄酮类植物雌激素，具有降低女性尿失禁症状风险的作用。该研究是首次证明尿中的植物雌激素水平与泌尿系统症状之间的相关性，前瞻性研究设计则是为了探讨其相关性间的作用机制。

目前已经在多种植物性食物中发现木酚素类植物雌激素，包括亚麻籽、芝麻、豆类、全谷物、水果和蔬菜。异黄酮植物雌激素类主要存在于大豆和豆制品中。

研究对2000年至2010年之间参加美国国家健康和营养调查（NHANES）的4,104女性进行分析发现，木酚素类植物雌激素肠内二醇、肠内脂的浓度增加均与急迫性尿失禁、尿失禁焦虑和对日常生活影响的可能性降低显著相关。Kreydin博士补充到，肠内二醇浓度增加与 “其他类型尿失禁”可能性降低显著相关。

急迫性尿失禁，其他类型尿失禁，尿失禁焦虑，以及尿失禁对日常活动影响在尿中肠内二醇和肠内脂浓度每单位变化的比值比分别为：0.43，0.49，0.32、0.14和0.47，0.32，0.30、0.24。

另外，本研究还发现异黄酮类植物雌激素与尿路症状减少无关。事实上，其中一种异黄酮植物雌激素类——染料木素——则与尿失禁的可能性增加相关（比值比，2.45）。

该研究受试对象均完成了泌尿系统功能检测和生活质量调查问卷，并接受了尿液植物性雌激素水平测定。在调整了包括年龄、种族、吸烟状况、身体质量指数、糖尿病、生育次数和绝经状态等已知的影响女性下尿路症状的因素后进行了泌尿系统症状评估。

Kreydin博士报告无相关经济利益冲突。

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By: SHARON WORCESTER, Ob.Gyn. News Digital Network

AT AUA ANNUAL MEETING

VITALS

Key clinical finding: A lignan-rich diet might protect women against urinary incontinence.

Major finding: Odds ratios for urinary symptoms per unit change in urinary enterodiol and enterolactone concentrations, respectively: 0.43, 0.49, 0.32, and 0.14, and 0.47, 0.32, 0.30, and 0.24 for urge incontinence, other incontinence, incontinence bother, and incontinence effect on daily activities.

Data source: An analysis of data from 4,104 NHANES participants.

Disclosures: Dr. Kreydin reported having no disclosures.

ORLANDO – Lignan-type phytoestrogens, but not isoflavone-type phytoestrogens, were associated with a decreased risk for incontinence symptoms in women, based on findings from a large prospective population-based cohort study.

Lignan-type phytoestrogens are found in a wide variety of plant-based foods including flaxseeds, sesame seeds, legumes, whole grains, fruits, and vegetables. Isoflavone-type phytoestrogens are found primarily in soybeans and soy-based products.

The study is the first to demonstrate an association between urinary phytoestrogen levels and urinary symptoms, according to the study’s author, Dr. Evgeniy I. Kreydin of Massachusetts General Hospital, Boston. Prospective studies are warranted to investigate the mechanism for this relationship, he added.

Increasing concentrations of the lignan phytoestrogens enterolactone and enterodiol were associated with significantly decreased likelihood of urge incontinence, bother from incontinence, and effect of urinary incontinence on daily living in 4,104 women who participated in the NHANES (National Health and Nutrition Examination Survey) between 2000 and 2010.

Increasing concentrations of enterolactone were also associated with significantly decreased likelihood of "other incontinence," Dr. Kreydin reported during an "outstanding posters" session at the annual meeting of the American Urological Association.

Odds ratios for urinary symptom s per unit change in urinary enterodiol and enterolactone concentrations, respectively, were 0.43, 0.49, 0.32, and 0.14, and 0.47, 0.32, 0.30. The odds ratio per unit change was 0.24 for urge incontinence, other incontinence, incontinence bother, and incontinence effect on daily activities, Dr. Kreydin said.

Alternatively, none of the isoflavone-type phytoestrogens was associated with decreased urinary symptoms in this study. In fact, one isoflavone-type phytoestrogen – genistein – was associated with an increased likelihood of incontinence bother (odds ratio, 2.45).

Study subjects completed a urinary function and quality of life questionnaire and underwent measurement of urinary phytoestrogen levels. Urinary symptoms were assessed after adjusting for age, race, smoking status, body mass index, diabetes, parity, and menopausal status – factors known to affect lower urinary tract symptoms in women.

Dr. Kreydin reported having no relevant financial disclosures.