Salari Sharif Pooneh, Nikfar Shekoufeh, Abdollahi Mohammad
Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, 16 Azar Ave, Tehran, Iran.
Age (Dordr). 2011 Sep;33(3):421-31. doi: 10.1007/s11357-010-9180-6. Epub 2010 Sep 9.
Phytoestrogens as selective estrogen receptor modulators like compounds may consider as a therapeutic option in osteoporosis. In this regard, the effect of phytoestrogens on bone biomarkers was examined in several trials which their results are controversial. We aimed this meta-analysis to evaluate the net effect of phytoestrogens on bone markers. A thorough search was conducted from 2000 to 2010 in English articles. All randomized clinical trials were reviewed, and finally, 11 eligible randomized clinical trials were selected for meta-analysis. Totally 1,252 postmenopausal women were enrolled in the study by considering the changes of pyridinoline (Pyd), desoxypyridinoline (Dpyd), bone alkaline phosphatase, and osteocalcin concentrations in urine and serum after phytoestrogens consumption. The urine Pyd and Dpyd levels decreased significantly in phytoestrogens consumers. Effect size and effect size for weighted mean difference of urine Pyd levels showed -1.229171 (95% confidence interval (CI) = -1.927639 to -0.530703) and -9.780623 (95% CI = -14.240401 to -5.320845), respectively, a significant results in comparison to control group and significant results for Dpyd -0.520132 (95% CI = -0.871988 to -0.168275) and -0.818582 (95% CI = -1.247758 to -0.389407), respectively. Meta-analysis indicates that phytoestrogens intake can prevent bone resorption, but its benefits on bone formation are not significant. This favorable effect was observed in low doses and in at least 3 weeks of phytoestrogens intake.
植物雌激素作为类似选择性雌激素受体调节剂的化合物,可能被视为骨质疏松症的一种治疗选择。在这方面,多项试验研究了植物雌激素对骨生物标志物的影响,但其结果存在争议。我们进行这项荟萃分析的目的是评估植物雌激素对骨标志物的总体影响。对2000年至2010年的英文文章进行了全面检索。对所有随机临床试验进行了综述,最终选择了11项符合条件的随机临床试验进行荟萃分析。通过考虑食用植物雌激素后尿液和血清中吡啶啉(Pyd)、脱氧吡啶啉(Dpyd)、骨碱性磷酸酶和骨钙素浓度的变化,共有1252名绝经后妇女参与了该研究。食用植物雌激素的人群尿液中Pyd和Dpyd水平显著降低。尿液Pyd水平加权平均差的效应量和效应量分别显示为-1.229171(95%置信区间(CI)=-1.927639至-0.530703)和-9.780623(95%CI=-14.240401至-5.320845),与对照组相比结果显著,Dpyd的效应量分别为-0.520132(95%CI=-0.871988至-0.168275)和-0.818582(95%CI=-1.247758至-0.389407)。荟萃分析表明,摄入植物雌激素可以预防骨吸收,但其对骨形成的益处并不显著。在低剂量且至少摄入3周植物雌激素时观察到了这种有益效果。