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大豆异黄酮提取物补充剂对成人血压的影响:随机安慰剂对照试验的系统评价和荟萃分析。

Effects of soy isoflavone extract supplements on blood pressure in adult humans: systematic review and meta-analysis of randomized placebo-controlled trials.

机构信息

Information Center, National Institute of Health and Nutrition, Tokyo, Japan.

出版信息

J Hypertens. 2010 Oct;28(10):1971-82. doi: 10.1097/HJH.0b013e32833c6edb.

Abstract

OBJECTIVE

Reported effects of different soy products on blood pressure vary. This systematic review and meta-analysis was performed to clarify the effects of soy isoflavone extract supplements on systolic and diastolic blood pressure (SBP and DBP) in adult humans.

METHODS

PubMed, CENTRAL, ICHUSHI, and CNKI were searched in June 2009 for relevant randomized placebo-controlled trials. Study data and indicators of methodological validity were independently extracted by two authors using predefined data fields. Meta-analysis was carried out in Review Manager 5.0.22.

RESULTS

Searches identified 3740 articles, of which 14 randomized controlled trials (789 participants) were included. Daily ingestion of 25-375 mg soy isoflavones (aglycone equivalents) for 2-24 weeks significantly decreased SBP by 1.92 mmHg (95% confidence interval -3.45 to -0.39; P = 0.01) compared with placebo (heterogeneity P = 0.39, fixed effect model) in adults with normal blood pressure and prehypertension. The effect was not lost on sensitivity analysis. Subgroup analyses suggest greater effects in studies longer than 3 months, in Western populations, at lower doses, and in studies at lower risk of bias. Soy isoflavones did not affect DBP [-0.13 (95% confidence interval -1.03 to 0.78) mmHg, P = 0.78; heterogeneity P = 0.20, fixed effect model].

CONCLUSION

Soy isoflavone extracts significantly decreased SBP but not DBP in adult humans, and no dose-response relationship was observed. Further studies are needed to address factors related to the observed effects of soy isoflavones on SBP and to verify the effect in hypertensive patients.

摘要

目的

不同大豆制品对血压的影响报道各异。本系统评价和荟萃分析旨在阐明大豆异黄酮提取物补充剂对成人收缩压和舒张压(SBP 和 DBP)的影响。

方法

检索 2009 年 6 月的 PubMed、CENTRAL、ICHUSHI 和 CNKI,以获取相关的随机安慰剂对照试验。两位作者使用预定义的数据字段,独立提取研究数据和方法学有效性指标。采用 Review Manager 5.0.22 进行荟萃分析。

结果

搜索共确定了 3740 篇文章,其中纳入了 14 项随机对照试验(789 名参与者)。与安慰剂相比,2-24 周内每天摄入 25-375mg 大豆异黄酮(苷元当量)可使血压正常和高血压前期成人的 SBP 降低 1.92mmHg(95%置信区间 -3.45 至 -0.39;P=0.01)(异质性 P=0.39,固定效应模型)。敏感性分析并未发现该结果有失。亚组分析提示,试验时间超过 3 个月、来自西方人群、剂量较低以及偏倚风险较低的研究中,效果更为显著。大豆异黄酮对 DBP 无影响[-0.13mmHg(95%置信区间 -1.03 至 0.78),P=0.78;异质性 P=0.20,固定效应模型]。

结论

大豆异黄酮提取物可显著降低成人 SBP,但对 DBP 无影响,且未观察到剂量-反应关系。需要进一步研究以明确与大豆异黄酮对 SBP 的观察效应相关的因素,并验证其在高血压患者中的效果。

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