Local Non Soy Isoflavone Attenuates Bone Loss In The Menopausal Women (original) (raw)
Related papers
Bone, 2010
Introduction: Effects of soy isoflavone supplements on bone turnover markers remain unclear. This up-todate systematic review and meta-analysis of randomized controlled trials (RCTs) was performed primarily to more completely and precisely clarify the effects on urinary deoxypyridinoline (DPD) and serum bone alkaline phosphatase (BAP) and secondarily to evaluate the effects on other bone turnover markers, compared with placebo in menopausal women. Methods: PubMed, CENTRAL, ICHUSHI, and CNKI were searched in June 2009 for relevant studies of RCTs. Data on study design, participants, interventions, and outcomes were extracted and methodological quality of each included trial was assessed. Results: From 3740 identified relevant articles, 10 (887 participants), 10 (1210 participants), and 8 (380 participants) RCTs were selected for meta-analysis of effects on DPD, BAP, and serum osteocalcin (OC), respectively, using Review Manager 5.0.22. Daily ingestion of an average 56 mg soy isoflavones (aglycone equivalents) for 10 weeks to 12 months significantly decreased DPD by 14.1% (95% CI: −26.8% to −1.5%; P = 0.03) compared to baseline (heterogeneity: P b 0.00001; I 2 = 93%; random effects model). The overall effect of soy isoflavones on DPD compared with placebo was a significant decrease of −18.0% (95% CI: −28.4% to −7.7%, P = 0.0007; heterogeneity: P = 0.0001; I 2 = 73%; random effects model). Subgroup analyses and metaregressions revealed that isoflavone dose and intervention duration did not significantly relate to the variable effects on DPD. Daily supplementation of about 84 mg and 73 mg of soy isoflavones for up to 12 months insignificantly increased BAP by 8.0% (95% CI: −4.2% to 20.2%, P = 0.20; heterogeneity: P b 0.00001; I 2 =98%) and OC by 10.3% (95% CI: −3.1% to 23.7%, P = 0.13; heterogeneity: P =0.002; I 2 = 69%) compared with placebo (random effects model), respectively. Conclusions: Soy isoflavone supplements moderately decreased the bone resorption marker DPD, but did not affect bone formation markers BAP and OC in menopausal women. The effects varied between studies, and further studies are needed to address factors relating to the observed effects of soy isoflavones on DPD and to verify effects on other bone turnover markers.
American Journal of Clinical Nutrition, 2009
Background: Isoflavones are naturally occurring plant estrogens that are abundant in soy. Although purported to protect against bone loss, the efficacy of soy isoflavone supplementation in the prevention of osteoporosis in postmenopausal women remains controversial. Objective: Our aim was to test the effect of soy isoflavone supplementation on bone health. Design: A multicenter, randomized, double-blind, placebo-controlled 24-mo trial was conducted to assess the effects of daily supplementation with 80 or 120 mg of soy hypocotyl aglycone isoflavones plus calcium and vitamin D on bone changes in 403 postmenopausal women. Study subjects were tested annually and changes in whole-body and regional bone mineral density (BMD), bone mineral content (BMC), and T scores were assessed. Changes in serum biochemical markers of bone metabolism were also assessed. Results: After study site, soy intake, and pretreatment values were controlled for, subjects receiving a daily supplement with 120 mg soy isoflavones had a statistically significant smaller reduction in whole-body BMD than did the placebo group both at 1 y (P , 0.03) and at 2 y (P , 0.05) of treatment. Smaller decreases in whole-body BMD T score were observed among this group of women at 1 y (P , 0.03) but not at 2 y of treatment. When compared with the placebo, soy isoflavone supplementation had no effect on changes in regional BMD, BMC, T scores, or biochemical markers of bone metabolism. Conclusion: Daily supplementation with 120 mg soy hypocotyl isoflavones reduces whole-body bone loss but does not slow bone loss at common fracture sites in healthy postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00665860.
Animal studies have shown that soy isoflavones have an effect in preventing estrogen-related bone loss, but few data are available in humans, especially in the Asian populations. This double-blind, placebo-controlled, randomized trial examines the effects of soy isoflavones on bone loss in postmenopausal Chinese women, aged 48 -62 yr. Two hundred and three eligible subjects were randomly assigned to three treatment groups with daily doses of placebo (1 g starch; n ؍ 67), middose (0.5 g starch, 0.5 g soy extracts, and ϳ40 mg isoflavones; n ؍ 68), and high dose (1.0 g soy extracts and ϳ80 mg isoflavones; n ؍ 68). All were given 12.5 mmol (500 mg) calcium and 125 IU vitamin D 3 . Bone mineral density (BMD) and bone mineral content (BMC) of the whole body, spine, and hip were measured using dual energy x-ray absorptiometry at baseline and 1 yr post treatment. Both univariate and multivariate analyses showed that women in the high dose group had mild, but statistically significantly, higher favorable change rate in BMC at the total hip and trochanter (P < 0.05) compared with the placebo and mid-dose groups, even after further adjustments for the potential confounding factors. Further stratified analyses revealed that the positive effects of soy isoflavone supplementation were observed only among women with lower initial baseline BMC (median or less). In conclusion, soy isoflavones have a mild, but significant, independent effect on the maintenance of hip BMC in postmenopausal women with low initial bone mass. (J Clin Endocrinol Metab 88: 4740 -4747, 2003)
Journal of Women's Health, 2010
The review's conclusions suggested that isoflavone mixtures are not effective in decreasing bone loss in perimenopausal and postmenopausal Western women. Limitations relating to searches, the statistical analyses, and the reporting of study quality means the authors' conclusions should be interpreted with caution. Searching MEDLINE and EMBASE were searched from 1990 to February 2010 for studies published in English; search terms were reported. Reference lists of selected articles and reviews were examined. Study selection Parallel-group randomised controlled trials (RCTs) of soy products (containing soy isoflavone) taken for at least three months by Western perimenopausal or postmenopausal women and that reported bone mineral density as an index of bone mass were eligible for inclusion. Comparator groups could not take phytoestrogens. Studies with main outcome measures that were markers of bone turnover were excluded. All studies except one were of postmenopausal women. Isoflavone doses (administered in various ways) ranged from 52 to 120mg/day of aglycone equivalents. All trials were placebo controlled. Most trials were conducted in USA. Treatment duration ranged from 24 weeks to three years. Two reviewers independently selected studies. Disagreements were resolved by a third reviewer. Assessment of study quality Study quality was evaluated independently by two reviewers who assessed selection bias, performance bias and attrition bias.
Effects of Soy Isoflavones on Markers of Bone Turnover in Premenopausal and Postmenopausal Women 1
The Journal of Clinical Endocrinology & Metabolism, 2000
Soy isoflavones are hypothesized to exert hormonal effects in women and thus may play a role in bone metabolism throughout life. In 2 randomized, cross-over studies, 14 pre-and 17 postmenopausal women were given 3 soy protein isolates containing different amounts of isoflavones [control, 0.13; low isoflavone (low-iso), 1.00; and highiso, 2.01 mg/kg body wt⅐day, averaging 8, 65, and 130 mg/day, respectively], for over 3 months each. Food records, blood samples, and 24-h urine collections were obtained throughout the studies. The endpoints evaluated included plasma or serum concentrations of bone-specific alkaline phosphatase, osteocalcin, insulin-like growth factor-I (IGFI), IGF binding protein-3 (IGFBP3), and urine concentrations of deoxypyridinoline cross-links and carboxy-terminal telopeptide of type I collagen. In premenopausal women, IGFI and IGFBP3 concentrations were increased by the low-iso diet, and deoxypyridinoline cross-links was increased by both the low-and highiso diets during certain phases of the menstrual cycle. In postmenopausal women, bone-specific alkaline phosphatase was decreased by both the low-and high-iso diets, and there were trends toward decreased osteocalcin, IGFI, and IGFBP3 concentrations with increasing isoflavone consumption. Although soy isoflavones do affect markers of bone turnover, the changes observed were of small magnitude and not likely to be clinically relevant. These data do not support the hypothesis that dietary isoflavones per se exert beneficial effects on bone turnover in women. (J Clin Endocrinol Metab 85: 3043-3048, 2000)
2011
Summary Introduction: the results of the works published on the role of isoflavones in the prevention of postme- nopausal osteoporosis are contradictory. The objective of our study is to evaluate the effects of nutritio- nal intervention with a milk product enriched with soy isoflavones on bone metabolism in Spanish pos- tmenopausal women. Subjects and methods: a randomised controlled double blind trial was carried out in 99 postmenopausal women who were allocated to two groups: group S (n=48), with a consumption of a milk product enri- ched with soy isoflavones (50mg/day), and group C (n=51), with a consumption of a control milk pro- duct over 12 months. Hormone parameters and markers for bone metabolism were assessed at the base- line and at one year. Ultrasound of the calcaneum (QUS, Hologic Sahara ® , North Carolina, US.) was used as the evaluation tool for bone mass. Results: at 12 months, a decrease in blood levels of tartrate-resistant acid phosphatase and osteoprotege- rin o...
American Journal of Clinical Nutrition, 2010
Background: Our previous study indicated that soy protein with isoflavones lessened lumbar spine bone loss in midlife women. Objective: We examined the efficacy of isoflavones (extracted from soy protein) on bone mineral density (BMD) in nonosteoporotic postmenopausal women. We hypothesized that isoflavone tablets would spare BMD, with biological (age, body weight, serum 25hydroxyvitamin D) and lifestyle (physical activity, dietary intake) factors modulating BMD loss. Design: Our double-blind, randomized controlled trial (36 mo) included healthy postmenopausal women (aged 45.8-65.0 y) with intent-to-treat (n = 224) and compliant (n = 208) analyses. Treatment groups consisted of a placebo control group and 2 soy isoflavone groups (80 compared with 120 mg/d); women received 500 mg calcium and 600 IU vitamin D 3 . Outcomes included lumbar spine, total proximal femur, femoral neck, and whole-body BMD. Results: Analysis of variance for intent-to-treat and compliant (80%) models, respectively, showed no treatment effect for spine (P = 0.46, P = 0.21), femur (P = 0.86, P = 0.46), neck (P = 0.17, P = 0.14), or whole-body (P = 0.86, P = 0.78) BMD. From baseline to 36 mo, BMD declined regardless of treatment. In intent-to-treat and compliant models, respectively, BMD decreases were as follows: spine (22.08%, 21.99%), femur (21.43%, 21.38%), neck (22.56%, 22.51%), and whole body (21.66%, 21.62%). Regression analysis (compliant model) indicated that age, whole-body fat mass, and bone resorption were common predictors of BMD change. After adjustment for these factors, 120 mg (compared with placebo) was protective (P = 0.024) for neck BMD. We observed no treatment effect on adverse events, endometrial thickness, or bone markers. Conclusion: Our results do not show a bone-sparing effect of extracted soy isoflavones, except for a modest effect at the femoral neck. This trial was registered at clinicaltrials.gov as NCT00043745. Am J Clin Nutr 2010;91:218-30.
Soy isoflavones for osteoporosis: An evidence-based approach
Maturitas, 2011
Effects of soy isoflavones on osteoporosis remain unclear. This review aimed to clarify the effect of soy isoflavones on bone mineral density (BMD) and turnover markers in menopausal women. PubMed and the Cochrane Library were searched in July 2011 for relevant meta-analyses of randomized controlled trials evaluating effects of soy isoflavones on BMD and bone turnover markers. Three meta-analyses evaluated the effects of soy isoflavones on lumbar spine, total hip, femoral neck, and trochanter BMD. Soy isoflavones significantly improved lumbar spine BMD in a moderate manner, but did not affect total hip, femoral neck, and trochanter BMD in menopausal women. Ingestion of soy isoflavones for six months appeared to be enough to exert a beneficial effect on lumbar spine BMD. Two meta-analyses evaluated the effects of soy isoflavones on a bone resorption marker (urine deoxypyridinoline) and two formation markers (serum alkaline phosphatase and osteocalcin). Soy isoflavones significantly decreased urine deoxypyridinoline in a moderate manner, but did not affect serum alkaline phosphatase and osteocalcin in menopausal women. Soy isoflavones may prevent postmenopausal osteoporosis and improve bone strength thus decreasing risk of fracture in menopausal women by increasing lumbar spine BMD and decreasing bone resorption marker urine deoxypyridinoline. Further studies are needed to address factors affecting the magnitude of the beneficial effects of soy isoflavones and to assess the possible interactions between soy isoflavones and anti-osteoporosis drugs, and to verify effects on BMD of other skeletal sites and other bone turnover markers.
Journal of Clinical Medicine
Postmenopausal osteoporosis is the most common form of osteoporosis and one of the major public health problems in developed countries. The prevalence of this condition, associated with the physiological stage of menopause, is continuously increasing. This study evaluated the effectiveness of soy isoflavones as compared to hormone replacement therapy (HRT) in low doses, on the prevention of postmenopausal osteoporosis, by determining bone mineral density (BMD) and urinary deoxypyridinoline (D-pyr) in physiological postmenopausal women. The study was conducted over a period of 12 months, on three parallel groups, which included a total of 325 postmenopausal women (HRT group: n = 95; phytoestrogens group: n = 124; control group: n = 106). At the one-year evaluation, we observed T-score normalization in a small number of cases (5.26%, 2.42% and 0.00%, respectively). The average values of D-Pyr decreased by 11.38% in the group treated with phytoestrogens (p < 0.05) and by 15.32% in t...