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大豆异黄酮补充剂和绝经期妇女的骨密度:一项为期 2 年的多中心临床试验。

Soy isoflavone supplementation and bone mineral density in menopausal women: a 2-y multicenter clinical trial.

机构信息

US Department of Agriculture/Agricultural Research Service, Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX 77030, USA.

出版信息

Am J Clin Nutr. 2009 Nov;90(5):1433-9. doi: 10.3945/ajcn.2009.28001. Epub 2009 Sep 16.

Abstract

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.

摘要

背景

异黄酮是一种天然存在的植物雌激素,在大豆中含量丰富。虽然据称其可以预防骨质流失,但大豆异黄酮补充剂预防绝经后妇女骨质疏松症的疗效仍存在争议。

目的

我们旨在测试大豆异黄酮补充剂对骨骼健康的影响。

设计

进行了一项多中心、随机、双盲、安慰剂对照的 24 个月试验,以评估每天补充 80 或 120 毫克大豆下胚轴糖苷异黄酮加钙和维生素 D 对 403 名绝经后妇女骨骼变化的影响。研究对象每年进行一次测试,并评估全身和局部骨矿物质密度(BMD)、骨矿物质含量(BMC)和 T 评分的变化。还评估了血清骨代谢生化标志物的变化。

结果

在控制研究地点、大豆摄入量和预处理值后,每天接受 120 毫克大豆异黄酮补充剂的受试者在 1 年(P < 0.03)和 2 年(P < 0.05)的治疗期间,全身 BMD 的减少幅度明显小于安慰剂组。在该组女性中,1 年时全身 BMD T 评分的下降幅度较小(P < 0.03),但在 2 年治疗期间则没有。与安慰剂相比,大豆异黄酮补充剂对局部 BMD、BMC、T 评分或骨代谢生化标志物的变化没有影响。

结论

每天补充 120 毫克大豆下胚轴异黄酮可减少全身骨丢失,但不能减缓健康绝经后妇女常见骨折部位的骨丢失。该试验在 clinicaltrials.gov 上注册为 NCT00665860。

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