This study explores the association between urinary lignan metabolites (enterolactone and enterodiol) and prevalent stroke (self-reported history of stroke), as well as the long-term likelihood of all-cause mortality (ACM) in patients with a history of stroke. This study employed a mixed-methods design integrating cross-sectional and retrospective cohort analyses, leveraging data from the National Health and Nutrition Examination Survey (NHANES) spanning the period 1999–2010. Eligible participants were those with complete data on urinary lignan metabolites (enterolactone and enterodiol), stroke status assessment, and long-term survival outcomes. Weighted logistic regression models were utilized to elucidate the association between enterolactone, enterodiol, and the likelihood of prevalent stroke, with subgroup analyses stratified by age and gender; effect sizes were quantified as odds ratios (ORs) with corresponding 95% confidence intervals (CIs). The study included 9,752 participants, among whom 194 were dead patients. Follow-up was conducted through December 2019, with a total duration of 164.97 ± 0.87 months. The analysis revealed no statistical association between enterodiol and prevalent stroke or ACM in patients with a history of stroke. Using the first quartile of enterolactone as a reference, the fourth quartile group of enterolactone was significantly associated with a lower likelihood of prevalent stroke (OR: 0.640.42-0.98), particularly in males (OR: 0.430.20-0.91) and those under the age of 65 years (OR: 0.430.19-0.97). Higher urinary enterolactone levels were associated with a lower likelihood of prevalent stroke and reduced ACM likelihood in patients with a history of stroke.
Zhang et al. (Thu,) studied this question.