Mei J, Yeung S S, Kung A W
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
J Clin Endocrinol Metab. 2001 Nov;86(11):5217-21. doi: 10.1210/jcem.86.11.8040.
Animal studies demonstrated that phytoestrogen had a protective effect against bone loss after ovariectomy. However, data on dietary phytoestrogen intake as well as its relationship with bone mineral density (BMD) in human are not available. Six hundred fifty southern Chinese women, aged 19 to 86 yr, were recruited to determine their dietary phytoestrogen intake by a food frequency questionnaire. BMDs at the lumbar spine and hip region were measured using dual energy x-ray absorptiometry. The subjects were analyzed according to various tertiles of phytoestrogen intake. Among the postmenopausal women (n = 357), significant differences in the lumbar spine (L2-4) BMD (0.820 +/- 0.145 vs. 0.771 +/- 0.131 g/cm2, P < 0.05) and Ward's triangle BMD (0.450 +/- 0.151 vs. 0.415 +/- 0.142 g/cm2; P < 0.05) were found between the highest and lowest intake of isoflavone after adjusting for age, height, weight, years since menopause, smoking, alcohol consumption, HRT usage, and daily calcium intake. Women with the highest intake of isoflavone had significantly lower levels of serum PTH (19.38 +/- 14.61 vs. 26.56 +/- 11.19 pg/ml; P < 0.05), osteocalcin (4.95 +/- 3.61 vs. 6.69 +/- 5.05 mg/liter; P = 0.05), and urinary N-telopeptide (34.18 +/- 25.31 vs. 49.66 +/- 41.00 nmol bone collagen equivalents/mmol creatinine; P < 0.05) when compared with those with the lowest intake of isoflavone. No association between dietary phytoestrogen intake and BMDs was seen in the premenopausal women with high endogenous E (n = 293). In conclusion, postmenopausal women with habitually high intake of dietary isoflavone are associated with higher BMD values at both the spine and hip region. Customarily high isoflavone intake may help to reverse the state of secondary hyperparathyroidism associated with E withdrawal and hence lower the rate of bone turnover in postmenopausal women.
动物研究表明，植物雌激素对卵巢切除术后的骨质流失具有保护作用。然而，关于人类膳食中植物雌激素的摄入量及其与骨矿物质密度（BMD）关系的数据尚不可得。招募了650名年龄在19至86岁之间的中国南方女性，通过食物频率问卷来确定她们膳食中植物雌激素的摄入量。使用双能X线吸收法测量腰椎和髋部区域的骨密度。根据植物雌激素摄入量的不同三分位数对受试者进行分析。在绝经后女性（n = 357）中，在调整年龄、身高、体重、绝经年限、吸烟、饮酒、激素替代疗法（HRT）使用情况和每日钙摄入量后，发现异黄酮摄入量最高组与最低组之间的腰椎（L2 - 4）骨密度（0.820 +/- 0.145 vs. 0.771 +/- 0.131 g/cm2，P < 0.05）和沃德三角区骨密度（0.450 +/- 0.151 vs. 0.415 +/- 0.142 g/cm2；P < 0.05）存在显著差异。与异黄酮摄入量最低的女性相比，异黄酮摄入量最高的女性血清甲状旁腺激素（PTH）水平显著降低（19.38 +/- 14.61 vs. 26.56 +/- 11.19 pg/ml；P < 0.05）、骨钙素水平（4.95 +/- 3.61 vs. 6.69 +/- 5.05 mg/升；P = 0.05）以及尿N - 端肽水平（34.18 +/- 25.31 vs. 49.66 +/- 41.00 nmol骨胶原当量/mmol肌酐；P < 0.05）。在内源性雌激素水平较高的绝经前女性（n = 293）中，未发现膳食植物雌激素摄入量与骨密度之间存在关联。总之，绝经后习惯性高摄入膳食异黄酮的女性，其脊柱和髋部区域的骨密度值较高。习惯性高异黄酮摄入可能有助于逆转与雌激素撤退相关的继发性甲状旁腺功能亢进状态，从而降低绝经后女性的骨转换率。
