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绝经后妇女 2 年补充大豆异黄酮的临床结局。

Clinical outcomes of a 2-y soy isoflavone supplementation in menopausal women.

机构信息

Department of Nutrition, University of California, Davis, CA 95616, USA.

出版信息

Am J Clin Nutr. 2011 Feb;93(2):356-67. doi: 10.3945/ajcn.110.008359. Epub 2010 Dec 22.

Abstract

BACKGROUND

Soy isoflavones are naturally occurring phytochemicals with weak estrogenic cellular effects. Despite numerous clinical trials of short-term isoflavone supplementation, there is a paucity of data regarding longer-term outcomes and safety.

OBJECTIVE

Our aim was to evaluate the clinical outcomes of soy hypocotyl isoflavone supplementation in healthy menopausal women as a secondary outcome of a trial 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 aglycone equivalent soy hypocotyl isoflavones plus calcium and vitamin D on the health of 403 postmenopausal women. At baseline and after 1 and 2 y, clinical blood chemistry values were measured and a well-woman examination was conducted, which included a mammogram and a Papanicolaou test. A cohort also underwent transvaginal ultrasound measurements to assess endometrial thickness and fibroids.

RESULTS

The baseline characteristics of the groups were similar. After 2 y of daily isoflavone exposure, all clinical chemistry values remained within the normal range. The only variable that changed significantly was blood urea nitrogen, which increased significantly after 2 y (P = 0.048) but not after 1 y (P = 0.343) in the supplementation groups. Isoflavone supplementation did not affect blood lymphocyte or serum free thyroxine concentrations. No significant differences in endometrial thickness or fibroids were observed between the groups. Two serious adverse events were detected (one case of breast cancer and one case of estrogen receptor-negative endometrial cancer), which was less than the expected population rate for these cancers.

CONCLUSION

Daily supplementation for 2 y with 80-120 mg soy hypocotyl isoflavones has minimal risk in healthy menopausal women. This trial was registered at clinicaltrials.gov as NCT00665860.

摘要

背景

大豆异黄酮是天然存在的植物化学物质,具有较弱的细胞雌激素效应。尽管有许多短期补充异黄酮的临床试验,但关于长期结果和安全性的数据却很少。

目的

我们的目的是评估大豆下胚轴异黄酮补充剂对健康绝经后妇女的临床效果,这是一项关于骨骼健康的试验的次要结果。

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 120mg 糖苷元当量大豆下胚轴异黄酮加钙和维生素 D 对 403 名绝经后妇女健康的影响。在基线和 1 年和 2 年后,测量了临床血液化学值,并进行了妇女健康检查,包括乳房 X 光检查和巴氏涂片检查。一个队列还进行了阴道超声测量,以评估子宫内膜厚度和肌瘤。

结果

两组的基线特征相似。在每天暴露异黄酮 2 年后,所有临床化学值均保持在正常范围内。唯一显著变化的变量是血尿素氮,在补充组中,2 年后显著增加(P=0.048),而 1 年后没有增加(P=0.343)。异黄酮补充剂不影响血淋巴细胞或血清游离甲状腺素浓度。两组之间子宫内膜厚度或肌瘤无显著差异。仅发现 2 例严重不良事件(1 例乳腺癌和 1 例雌激素受体阴性子宫内膜癌),低于这些癌症的预期人群发生率。

结论

健康绝经后妇女每天补充 80-120mg 大豆下胚轴异黄酮 2 年的风险极小。该试验在 clinicaltrials.gov 上注册为 NCT00665860。

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