Hooper L, Ryder J J, Kurzer M S, Lampe J W, Messina M J, Phipps W R, Cassidy A
School of Medicine, Health Policy and Practice, University of East Anglia, Norwich NR4 7TJ, UK.
Hum Reprod Update. 2009 Jul-Aug;15(4):423-40. doi: 10.1093/humupd/dmp010. Epub 2009 Mar 19.
BACKGROUND Hormonal effects of soy and isoflavones have been investigated in numerous trials with equivocal findings. We aimed to systematically assess the effects of soy and isoflavones on circulating estrogen and other hormones in pre- and post-menopausal women. METHODS The Cochrane Library, MEDLINE and EMBASE (plus reviews and experts) were searched to December 2007. Inclusion of randomized or residential crossover trials of soy or isoflavones for 4 or more weeks on estrogens, SHBG, FSH, LH, progesterone and thyroid hormones in women was assessed independently in duplicate. Six percent of papers assessed were included. Data concerning participants, interventions, outcomes, potential effect modifiers and trial quality characteristics were extracted independently in duplicate. RESULTS Forty-seven studies (11 of pre-, 35 of post- and 1 of perimenopausal women) were included. In premenopausal women, meta-analysis suggested that soy or isoflavone consumption did not affect primary outcomes estradiol, estrone or SHBG concentrations, but significantly reduced secondary outcomes FSH and LH [by approximately 20% using standardized mean difference (SMD), P = 0.01 and 0.05, respectively]. Menstrual cycle length was increased by 1.05 days (95% CI 0.13, 1.97, 10 studies). In post-menopausal women, there were no statistically significant effects on estradiol, estrone, SHBG, FSH or LH, although there was a small statistically non-significant increase in total estradiol with soy or isoflavones ( approximately 14%, SMD, P = 0.07, 21 studies). CONCLUSIONS Isoflavone-rich soy products decrease FSH and LH in premenopausal women and may increase estradiol in post-menopausal women. The clinical implications of these modest hormonal changes remain to be determined.
大豆和异黄酮的激素效应已在众多试验中进行了研究，但结果不一。我们旨在系统评估大豆和异黄酮对绝经前和绝经后女性循环雌激素及其他激素的影响。方法：检索至2007年12月的Cochrane图书馆、MEDLINE和EMBASE（以及综述和专家意见）。对纳入的关于女性食用大豆或异黄酮4周及以上对雌激素、性激素结合球蛋白（SHBG）、促卵泡激素（FSH）、促黄体生成素（LH）、孕酮和甲状腺激素影响的随机或居家交叉试验进行双人独立评估。被评估的论文中有6%被纳入。关于参与者、干预措施、结局、潜在效应修饰因素和试验质量特征的数据由两人独立重复提取。结果：纳入了47项研究（11项针对绝经前女性，35项针对绝经后女性，1项针对围绝经期女性）。在绝经前女性中，荟萃分析表明食用大豆或异黄酮不影响主要结局雌二醇、雌酮或SHBG浓度，但显著降低次要结局FSH和LH[使用标准化均数差（SMD）分别降低约20%，P = 0.01和0.05]。月经周期长度增加了1.05天（95%可信区间0.13，1.97，10项研究）。在绝经后女性中，对雌二醇、雌酮、SHBG、FSH或LH没有统计学显著影响，尽管食用大豆或异黄酮后总雌二醇有小幅统计学上不显著的增加（约14%，SMD，P = 0.07，21项研究）。结论：富含异黄酮的大豆制品可降低绝经前女性的FSH和LH，并可能增加绝经后女性的雌二醇。这些适度激素变化的临床意义仍有待确定。
