Velasquez M T, Bhathena S J
Am J Kidney Dis. 2001 May;37(5):1056-68. doi: 10.1016/s0272-6386(05)80025-3.
There is growing evidence that dietary phytoestrogens have a beneficial role in chronic renal disease. This review summarizes the recent findings from dietary intervention studies performed in animals and humans suggesting that consumption of soy-based protein rich in isoflavones and flaxseed rich in lignans retards the development and progression of chronic renal disease. In several animal models of renal disease, both soy protein and flaxseed have been shown to limit or reduce proteinuria and renal pathological lesions associated with progressive renal failure. In studies of human subjects with different types of chronic renal disease, soy protein and flaxseed also appear to moderate proteinuria and preserve renal function. However, most of these clinical trials were of relatively short duration and involved a small number of patients. Furthermore, it is not clear whether the renal protective effects of soy protein and flaxseed are caused by the isoflavones (daidzein and genistein) and lignans (matairesinol and secoisolariciresinol) or some other component. The biochemistry, metabolism, and mechanisms of actions of isoflavones and lignans are discussed. Isoflavones and lignans appear to act through various mechanisms that modulate cell growth and proliferation, extracellular matrix synthesis, inflammation, and oxidative stress. Some of these actions have been shown in vitro, but studies of the mechanisms operative in vivo are lacking. The diversity of cellular actions of isoflavones and lignans supports their protective effects in a variety of experimental and human types of chronic renal disease. Further investigations are needed to evaluate their long-term effects on renal disease progression in patients with chronic renal failure.
越来越多的证据表明，膳食植物雌激素在慢性肾病中具有有益作用。本综述总结了在动物和人类中进行的膳食干预研究的最新发现，表明食用富含异黄酮的大豆蛋白和富含木脂素的亚麻籽可延缓慢性肾病的发展和进展。在几种肾病动物模型中，大豆蛋白和亚麻籽均已显示出可限制或减少与进行性肾衰竭相关的蛋白尿和肾脏病理损伤。在对患有不同类型慢性肾病的人类受试者的研究中，大豆蛋白和亚麻籽似乎也能减轻蛋白尿并保留肾功能。然而，这些临床试验大多持续时间相对较短，且涉及的患者数量较少。此外，尚不清楚大豆蛋白和亚麻籽的肾脏保护作用是由异黄酮（大豆苷元和染料木黄酮）和木脂素（matairesinol和开环异落叶松树脂酚）还是其他成分引起的。本文讨论了异黄酮和木脂素的生物化学、代谢及作用机制。异黄酮和木脂素似乎通过多种机制发挥作用，这些机制可调节细胞生长和增殖、细胞外基质合成、炎症和氧化应激。其中一些作用已在体外得到证实，但缺乏对体内作用机制的研究。异黄酮和木脂素细胞作用的多样性支持了它们在各种实验性和人类慢性肾病类型中的保护作用。需要进一步研究以评估它们对慢性肾衰竭患者肾病进展的长期影响。
