Flavonoids and breast cancer risk in Italy.

Few epidemiologic studies have investigated the potential relation between flavonoids and breast cancer risk. We have applied recently published data on the composition of foods and beverages in terms of six principal classes of flavonoids (i.e., flavanones, flavan-3-ols, flavonols, flavones, anthocyanidines, and isoflavones) on dietary information collected in a large-case control study of breast cancer conducted in Italy between 1991 and 1994. The study included 2,569 women with incident, histologically confirmed breast cancer, and 2,588 hospital controls. Odds ratios (OR) and 95% confidence intervals were estimated by multiple logistic regression models. After allowance for major confounding factors and energy intake, a reduced risk of breast cancer was found for increasing intake of flavones (OR, 0.81, for the highest versus the lowest quintile; P-trend, 0.02), and flavonols (OR, 0.80; P-trend, 0.06). No significant association was found for other flavonoids, including flavanones (OR, 0.95), flavan-3-ols (OR, 0.86), anthocyanidins (OR, 1.09), as well as for isoflavones (OR, 1.05). The findings of this large study of an inverse association between flavones and breast cancer risk confirm the results of a Greek study.     

Associations of placental weight with maternal and cord blood hormones

PurposePlacental weight has been associated with mammographic pattern and coronary heart disease in the adult offspring, but the mechanisms are unknown. We evaluated the associations of maternal and cord blood hormones with placental weight in normal pregnancies.MethodsProspective study of 167 normal singleton pregnancies in Boston, USA and 256 in Shanghai, China. Maternal hormone levels at the 27th gestational week were available for all pregnancies. Cord blood measurements were available for 86 pregnancies in Boston and 104 in Shanghai. Pearson partial correlation coefficients of log-transformed hormone levels with placental weight were calculated.ResultsMaternal levels of estriol, testosterone, and progesterone (P < .05) were positively associated with placental weight. There was no such evidence for adiponectin, prolactin, and insulin-like growth factor (IGF)-I. Cord blood steroids tended to be inversely associated with placental weight, the results being statistically significant for testosterone (P < .05). There was a marginally significant positive association of cord blood IGF-I with placental weight. Reported results were adjusted for study center.ConclusionsPlacental weight appears to be positively correlated with maternal steroids. Its correlation with cord blood steroids, however, appears inverse, compatible with negative feedback mechanisms. There is also a suggestion for placental weight to be positively associated with cord blood IGF-I.     

Maternal and cord blood hormones in relation to birth size

Birth size has been associated with adult life diseases, but the endocrine factors that are likely involved are not established. We evaluated the associations of maternal and cord blood hormones with birth size in normal pregnancies, and examined possible effect modification by maternal height, on the basis of prior suggestive evidence. In a prospective study of normal singleton pregnancies in Boston, USA and Shanghai, China, maternal hormone levels at the 27th gestational week were available for 225 pregnancies in Boston and 281 in Shanghai and cord blood measurements for 92 pregnancies in Boston and 110 in Shanghai. Pearson partial correlation coefficients of log-transformed hormone levels with birth weight and length were calculated. Overall, positive correlations with birth weight were found for maternal estriol (r = 0.19; p < 0.001) and progesterone (r = 0.15; p < 0.001) and these associations were more evident among taller mothers. There was an inverse association of cord blood progesterone (r = ?0.16; p < 0.03) with birth weight. In Boston, cord blood IGF-1 was positively associated with birth weight (r = 0.22; p < 0.04) and length (r = 0.25; p < 0.02), particularly among taller mothers (r = 0.43 and 0.38, respectively; p < 0.02), whereas among taller mothers in Shanghai the associations of IGF-2 with birth size appeared to be at least as strong as those of IGF-1. In conclusion, maternal estriol and progesterone, and cord blood IGF-1 were positively correlated with birth size. All correlations tended to be more pronounced among offspring of taller mothers. Among taller mothers in Shanghai, IGF-2 appeared to be at least as strongly associated with birth size as IGF-1.     

Vegetables and fruits in relation to cancer risk: evidence from the Greek EPIC cohort study.

INTRODUCTION: Vegetables and fruits have long been considered as conducive to cancer prevention, but this view has recently been challenged. We investigated the relation of vegetable and fruit intake with total cancer occurrence in the population-based cohort of the Greek component of the European Prospective Investigation into Cancer and nutrition (EPIC), which is characterized by high consumption of these foods. MATERIALS AND METHODS: For a median of 7.9 years, 25,623 participants (10,582 men, 15,031 women) were actively followed-up, contributing 188,042 person-years. Cancer at any site was diagnosed in 851 participants (421 men, 430 women). Dietary intakes were ascertained at enrollment through an extensive, validated, interviewer-administered food frequency questionnaire. Data were analyzed through Cox regression, controlling for potential confounders. RESULTS: An inverse association of cancer incidence with vegetables and fruits (mutually adjusted) was noted, reaching statistical significance for vegetables among women. When vegetables and fruits were combined, the inverse association with cancer occurrence was statistically significant for the entire cohort [hazard ratio per increasing quintile, 0.94; 95% confidence interval (95% CI), 0.88-0.99], as well as among women (hazard ratio per increasing quintile, 0.90; 95% CI, 0.83-0.98), but not among men (hazard ratio per increasing quintile, 0.95; 95% CI, 0.87-1.04). CONCLUSIONS: In a general population-based Greek cohort, we have found evidence that consumption of vegetables and fruits is inversely associated with incidence of cancer overall, although the associations seem to be weaker than expected on the basis of case-control studies previously undertaken in Greece.     

Oesophageal adenocarcinoma: A paradigm of mechanical carcinogenesis?

Incidence of adenocarcinoma of the oesophagus and gastric cardia is increasing in most developed countries and strongly associated with obesity and male gender. An underlying increase in the prevalence of gastro-oesophageal reflux has generally been postulated. We suggest that the increase in frequency of reflux and the 2 associated forms of cancer can be explained by growing abdominal pressure brought about by increasing central obesity, most common among men, and sedentary lifestyle, including car use. Abdominal pressure is further accentuated mainly in men by the shift in Western male dressing towards the general use of belts.     

Abruptio placentae and idiopathic arterial calcification in a stillborn.

We report a case of idiopathic arterial calcification in a stillborn of 22 weeks gestational age. The pregnancy was complicated by abruptio placentae and the postmortem examination showed widespread arterial calcification in the placenta, as well as in the pulmonary, renal, cerebellar, and brain arteries.     

Genetic implications of bilateral breast cancer: a population based cohort study

BACKGROUND: Women with breast cancer are at high risk of bilateral breast cancer. We aimed to assess the incidence of bilateral breast cancer in relation to age and time since diagnosis of first cancer. METHODS: We analysed a population-based cohort of 123757 women with a first primary breast cancer diagnosed in Sweden from 1970 to 2000 for frequency of bilateral breast cancers and deaths by means of record linkage. Second primary breast cancers were categorised as synchronous bilateral breast cancers if diagnosed within 3 months of the first primary cancer or as metachronous if diagnosed more than 3 months after diagnosis of first primary cancer. FINDINGS: We identified 6550 women who had developed bilateral breast cancer. Age-incidence patterns of synchronous and unilateral breast cancer were similar, although the absolute rates of synchronous bilateral cancer were 50-100 times lower than those of unilateral cancer. A woman aged 80 years or older is at least twice as likely to be diagnosed with synchronous bilateral breast cancer than is a woman younger than 40 years. In the first 20 years after diagnosis of primary breast cancer, incidence of metachronous bilateral cancer decreased from about 800 per 10(5) person-years to 400 per 10(5) person-years in patients diagnosed with primary breast cancer before the age of 45 years, whereas incidence remained at 500-600 per 10(5) person-years in those age 45 years or older at diagnosis. After 30 years' follow-up, cumulative risk of metachronous bilateral breast cancer was about 15% irrespective of age at first primary breast cancer. INTERPRETATION: The higher than expected risk of synchronous bilateral breast cancer could be explained by non-genetic factors. By contrast, incidence of metachronous bilateral cancer fits neither a model of highly penetrant genes nor aggregation of environmental risk factors.     

A prospective study of pregravid oral contraceptive use in relation to fetal growth

OBJECTIVE: Because oral contraceptives are so widely used, any health consequences may have substantial public health implications. Whether pregravid oral contraceptives could affect subsequent pregnancies has not been adequately studied. The study objectives were to examine whether pregravid oral contraceptive use affects fetal growth and pregnancy hormone levels. DESIGN: A prospective study of pregnant women followed through pregnancy. SETTING: A major teaching hospital in Boston, USA. POPULATION: Two hundred and sixty Caucasian pregnant women, with a mean age of 31, and a parity of no more than two. Seventy-nine percent of the women were pregravid oral contraceptive users. METHODS: Exposure and covariate data were collected through structured questionnaires. Blood was drawn for hormonal analysis during the 16th and 27th gestational week. Information on pregravid oral contraceptive use included duration and recency of use, and oral contraceptive formulation. Multivariate regression models were used to examine the effect of pregravid oral contraceptive use on birth outcomes and the studied pregnancy hormones. MAIN OUTCOME MEASURES: Birthweight, placental weight, gestational age, pregnancy hormone levels of oestriol and progesterone at 16th and 27th gestational week. RESULTS: Adjusting for confounders, pregravid oral contraceptive use increased birthweight (mean difference =+207.3 g, 95% CI =+77.6 to +337.1) and placental weight (mean difference =+64.9 g, 95% CI =+13.0 to +116.9) compared with never use. Women with prior oral contraceptive use had higher levels of serum progesterone (P= 0.002) and oestriol (P= 0.12) at the 27th gestational week measurement. The effect on birthweight, placental weight and hormones was stronger among those using oral contraceptives in the previous year and those using a high progestin/high oestrogen potency preparation. CONCLUSIONS: Pregravid oral contraceptive use is positively associated with fetal growth, and this effect may be mediated through oestriol and progesterone.     

Nausea and vomiting in pregnancy in relation to prolactin,estrogens, and progesterone: a prospective study

OBJECTIVE: To assess pregnancy hormone levels in relation to nausea with or without vomiting. METHODS: In the context of a prospective cohort study, 262 white pregnant women in Boston were observed through delivery. Maternal blood was collected at 16 and 27 weeks' gestation and serum levels of estradiol, estriol, progesterone, prolactin, and sex hormone-binding globulin were determined. Information on sociodemographic and medical variables was collected through an interviewer-administered questionnaire and review of medical records. At the 27th gestational week, nausea with or without vomiting at any time during the index pregnancy was ascertained. RESULTS: By the 27th gestational week, 209 women (79.8%) had experienced nausea with or without vomiting. There was a substantial and statistically significant (P <.01) inverse association of prolactin with nausea with or without vomiting at both the first and the second samplings, with or without adjustment for the other measured compounds. Estradiol was positively associated with nausea with or without vomiting risk, but the association was evident only after adjustment for the other measured compounds (P values of.06 and.07 at the first and second samplings, respectively). We found no evidence that estriol, progesterone, or sex hormone-binding globulin was related to nausea with or without vomiting at either the 16th or the 27th week of pregnancy. CONCLUSION: Our results point to lower levels of prolactin and, perhaps, higher levels of estradiol as contributing to or correlating with the occurrence of nausea with or without vomiting at any time during the pregnancy until the 27th gestational week. We found no evidence that estriol, progesterone, or sex hormone-binding globulin is associated with this condition.     

Pregnancy estriol,estradiol, progesterone and prolactin in relation to birth weight and other birth size variables (United States)

Objective: Because birth weight has been positively associated with adult life breast cancer risk and pregnancy estrogens have been hypothesized to affect breast cancer risk in the offspring, we have evaluated the association of pregnancy estriol (E3), estradiol (E2), progesterone and prolactin in maternal serum samples collected during the 16th and 27th gestational week with birth size parameters. Methods: Prospective study of 230 Caucasian women who delivered a live singleton after 37–42 weeks of gestation. Results: E3 at the 27th gestational week was significantly positively associated with birth weight, birth length and placental weight. Progesterone at the 27th gestational week was also significantly positively associated with birth weight and placental weight but, after mutual adjustment among the studied pregnancy hormones, these associations weakened considerably. There was also inconsistent evidence that SHBG and prolactin at the 27th gestational week may be respectively positively and inversely related with birth size parameters. Measurements during the 16th gestational week were generally unrelated to birth size parameters. Conclusions: Because E3 is a dominant estrogen during pregnancy, the positive association of it with birth weight allows the use of the latter as a proxy of in utero exposure to estrogens in breast cancer investigations.