title: Soy isoflavone intake is associated with risk of Kawasaki disease.
abstract: Kawasaki disease (KD) is an acute vasculitis affecting children. Incidence of KD varies according to ethnicity and is highest in Asian populations. Although genetic differences may explain this variation, dietary or environmental factors could also be responsible. The objectives of this study were to determine dietary soy and isoflavone consumption in a cohort of KD children just before disease onset and their mothers' intake during pregnancy and nursing. We tested the hypothesis that soy isoflavone consumption is associated with risk of KD in US children, potentially explaining some of the ethnic-cultural variation in incidence. We evaluated soy food intake and isoflavone consumption in nearly 200 US KD cases and 200 age-matched controls using a food frequency questionnaire for children and in their mothers. We used a logistic regression model to test the association of isoflavones and KD. Maternal surveys on soy intake during pregnancy and nursing showed no significant differences in isoflavone consumption between groups. However, we identified significantly increased KD risk in children for total isoflavone (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.37-3.96) and genistein (OR, 2.46; 95% CI, 1.46-4.16) intakes, when comparing high soy consumers vs nonconsumers. In addition, significantly increased KD risk occurred in Asian-American children with the highest consumption (total isoflavones: OR, 7.29; 95% CI, 1.73-30.75; genistein: OR, 8.33; 95% CI, 1.92-36.24) compared to whites. These findings indicate that childhood dietary isoflavone consumption, but not maternal isoflavone intake during pregnancy and nursing, relates to KD risk in an ethnically diverse US population.
authors.affiliation: Division of Cardiology, Department of Pediatrics, University of Washington, Seattle, WA, USA; Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, WA, USA. Electronic address: michael.portman@seattlechildrens.org.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Portman
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Sandi L
authors.initials: SL
authors.lastname: Navarro
authors.affiliation: Center for Developmental Therapeutics, Seattle Children's Research Institute, Seattle, WA, USA.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Bruce
authors.affiliation: Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA; Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Johanna W
authors.initials: JW
authors.lastname: Lampe
mesh_terms: D001213:Asian; D002648:Child; D002675:Child, Preschool; D004032:Diet / Q000009:adverse effects*; D015930:Diet Records; D004034:Diet Surveys; D005260:Female; D019833:Genistein / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007223:Infant; D007529:Isoflavones / Q000008:administration & dosage* / Q000009:adverse effects*; D008297:Male; D008431:Maternal-Fetal Exchange; D009080:Mucocutaneous Lymph Node Syndrome / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D045730:Soy Foods / Q000009:adverse effects; D013025:Glycine max / Q000737:chemistry*; D011795:Surveys and Questionnaires
chemical_list: D007529:Isoflavones; D019833:Genistein
keywords: Autoimmune; Isoflavones; Kawasaki disease; Mucocutaneous lymph node syndrome; Phytoestrogens