Anderson J J, Anthony M, Messina M, Garne S C
Department of Nutrition, Schools of Public Health and Medicine, University of North Carolina, Chapel Hill, NC 27599-7400, USA.
Nutr Res Rev. 1999 Jun;12(1):75-116. doi: 10.1079/095442299108728875.
Recent investigations on the effects of phyto-oestrogens on various tissues have revealed that these diverse molecules may improve human health, particularly by protecting against certain chronic diseases. After a brief examination of the food sources, structures, and general cellular actions of the major phyto-oestrogens, current research findings on cardiovascular disease, skeletal tissues, and reproductive cancers are reviewed. Phyto-oestrogen concentrations in blood may be maintained at high levels in those consuming soyabean (Glycine max)-based food daily at several meals and exert their effects on target cells through either genomic effects via the classical oestrogen receptors or non-genomic effects mediated by membrane-bound oestrogen receptors or other cellular proteins. The expression of oestrogen receptor (OR) subtypes alpha (a) and beta (beta) varies across tissues, and cells that preferentially express OR-beta, which may include bone cells, are more likely to respond to phyto-oestrogens. Conversely, reproductive tissues contain relatively more OR-a and may, thus, be differently affected by phyto-oestrogens. Soyabean phyto-oestrogens appear to prevent the progression of atherosclerosis through multiple interactions, including lowering of plasma lipids and lipoproteins, increased vasodilatation and, possibly, decreased activation of blood platelets and vascular smooth muscle cells. However, a favourable impact on cardiovascular disease morbidity and mortality by a soyabean-enriched western-type diet remains to be shown, and unresolved questions remain regarding dose and form of the phyto-oestrogens in relation to risks and benefits. The isoflavones of soyabean have been shown consistently to have bone-retentive effects in animal studies by several investigators using rodent models, although intakes must be above a relatively high threshold level for a lengthy period of time, and little or no extra benefit is observed with intakes above this threshold level. The reports of modest or no effects on prevention of bone loss in human and non-human primate studies respectively, may be due to the limited doses tested so far. The relationship between soyabean-food intake and cancer risk has been more extensively investigated than for any other disease, but with less certainty about the benefits of long-term consumption of phyto-oestrogen-containing foods on prevention of cancer. The observations that breast and prostate cancer rates are lower in Asian countries, where soyabean foods are consumed at high levels, and the high isoflavone content of soyabeans have led to examination of the potential protective effects of phyto-oestrogens. Establishing diet-cancer relationships has proved difficult, in part because of the conflicting data from various studies of effects of soyabean-diets on cancer. Epidemiological evidence, though not impressive, does suggest that soyabean intake reduces breast cancer risk. The isoflavone genistein has a potent effect on breast cancer cells in vitro, and early exposure of animals to genistein has been effective in reducing later development of mammary cancer. Thus, continuous consumption of soyabean foods in early life and adulthood may help explain the low breast cancer mortality rates in Asian countries. Although the evidence for a protective effect against prostate cancer may be slightly more supportive, more research is needed before any firm conclusions can be made about the phyto-oestrogen-cancer linkages.
近期关于植物雌激素对各种组织影响的研究表明,这些多样的分子可能改善人类健康,特别是通过预防某些慢性疾病。在简要考察主要植物雌激素的食物来源、结构和一般细胞作用之后,本文综述了目前关于心血管疾病、骨骼组织和生殖系统癌症的研究发现。每日多餐食用以大豆(Glycine max)为基础食物的人群,其血液中的植物雌激素浓度可能维持在较高水平,并通过经典雌激素受体的基因组效应或膜结合雌激素受体或其他细胞蛋白介导的非基因组效应作用于靶细胞。雌激素受体(ER)亚型α(α)和β(β)在不同组织中的表达各异,优先表达ER-β的细胞(可能包括骨细胞)更有可能对植物雌激素产生反应。相反,生殖组织中ER-α相对较多,因此可能受到植物雌激素的不同影响。大豆植物雌激素似乎通过多种相互作用预防动脉粥样硬化的进展,包括降低血脂和脂蛋白、增加血管舒张,以及可能减少血小板和血管平滑肌细胞的活化。然而,富含大豆的西式饮食对心血管疾病发病率和死亡率的有利影响仍有待证实,关于植物雌激素的剂量和形式与风险和益处的关系仍存在未解决的问题。几位研究人员使用啮齿动物模型进行的动物研究一致表明,大豆异黄酮在动物研究中具有保骨作用,尽管摄入量必须在较长时间内高于相对较高的阈值水平,且高于此阈值水平时几乎没有额外益处。关于人类和非人类灵长类动物研究分别对预防骨质流失影响不大或无影响的报告,可能是由于迄今为止测试的剂量有限。与任何其他疾病相比,大豆食品摄入量与癌症风险之间的关系得到了更广泛的研究,但关于长期食用含植物雌激素食物对预防癌症的益处仍不太确定。在亚洲国家,大豆食品摄入量较高,乳腺癌和前列腺癌发病率较低,以及大豆中异黄酮含量高,这些观察结果促使人们研究植物雌激素的潜在保护作用。事实证明,建立饮食与癌症的关系很困难,部分原因是关于大豆饮食对癌症影响的各种研究数据相互矛盾。流行病学证据虽然不令人信服,但确实表明摄入大豆可降低乳腺癌风险。异黄酮染料木黄酮在体外对乳腺癌细胞有显著作用,动物早期接触染料木黄酮可有效降低后期乳腺癌的发生。因此,在生命早期和成年期持续食用大豆食品可能有助于解释亚洲国家乳腺癌死亡率较低的原因。尽管有更多证据支持植物雌激素对前列腺癌有保护作用,但在对植物雌激素与癌症的联系得出任何确凿结论之前,还需要更多的研究。