% IMPORTANT: The following is UTF-8 encoded.  This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.

@ARTICLE{Jaskulski:141420,
      author       = {S. Jaskulski$^*$ and A. Y. Jung$^*$ and S. Behrens$^*$ and
                      T. S. Johnson$^*$ and R. Kaaks$^*$ and K. Thöne and D.
                      Flesch-Janys and D. Sookthai$^*$ and J. Chang-Claude$^*$},
      title        = {{C}irculating enterolactone concentrations and prognosis of
                      postmenopausal breast cancer: assessment of mediation by
                      inflammatory markers.},
      journal      = {International journal of cancer},
      volume       = {143},
      number       = {11},
      issn         = {0020-7136},
      address      = {Bognor Regis},
      publisher    = {Wiley-Liss},
      reportid     = {DKFZ-2018-01926},
      pages        = {2698 - 2708},
      year         = {2018},
      abstract     = {Higher lignan exposure has been associated with lower
                      all-cause mortality (ACM) and breast cancer-specific
                      mortality (BCSM) for postmenopausal breast cancer patients.
                      However, the biological mechanisms underpinning these
                      associations are still unclear. We investigated for the
                      first time whether and to what extent the association
                      between enterolactone (ENL), the major lignan metabolite,
                      and postmenopausal breast cancer prognosis is mediated by
                      inflammatory biomarkers. Circulating concentrations of ENL
                      and inflammatory markers were measured in a population-based
                      prospective cohort of 1,743 breast cancer patients recruited
                      between 2002 and 2005 and followed-up until 2009. Hazard
                      ratios (HR) and $95\%$ CIs were estimated using
                      multivariable Cox regression. Mediation analysis was
                      performed to estimate the percentage association between ENL
                      (log2) and ACM, BCSM and distant disease-free survival
                      (DDFS), which is mediated by C-reactive protein (CRP)
                      (log2), as the strongest potential mediator, and also
                      interleukin (IL)-10. Median serum/plasma ENL and CRP
                      concentrations for all patients, including 180 deceased
                      patients, were 23.2 and 17.5 nmol/L, and 3.2 and 6.5 mg/l,
                      respectively. ENL concentrations were significantly
                      inversely associated with ACM, BCSM and DDFS (per doubling
                      of ENL concentrations: HRs 0.93 [0.87, 0.99], 0.91 [0.84,
                      0.99] and 0.92 [0.87, 0.99]), after adjusting for prognostic
                      factors and BMI. Estimated 18, 14 and $12\%$ of the effects
                      of ENL on ACM, BCSM and DDFS, respectively, were mediated
                      through CRP. No mediational effect of IL-10 was found. We
                      provide first evidence that the proinflammatory marker CRP
                      may partially mediate the association of ENL with
                      postmenopausal breast cancer survival, which supports
                      hormone-independent mechanisms.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29974464},
      doi          = {10.1002/ijc.31647},
      url          = {https://inrepo02.dkfz.de/record/141420},
}