Center for Autonomic and Peripheral Nerve Disorders, Beth Israel Medical Deaconess Center, Harvard Medical School, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Nutrition. 2011 Jul-Aug;27(7-8):859-62. doi: 10.1016/j.nut.2010.10.018. Epub 2011 Feb 25.
Previous research has focused on the beneficial effects of soy and its active ingredients, isoflavones. For instance, soy consumption has been associated with lower cardiovascular and breast cancer risks. However, the number of reports demonstrating adverse effects of isoflavones due to their estrogenlike properties has increased. We present the case of a 19-y-old type 1 diabetic but otherwise healthy man with sudden onset of loss of libido and erectile dysfunction after the ingestion of large quantities of soy-based products in a vegan-style diet. Blood levels of free and total testosterone and dehydroepiandrosterone (DHEA) were taken at the initial presentation for examination and continuously monitored up to 2 y after discontinuation of the vegan diet. Blood concentrations of free and total testosterone were initially decreased, whereas DHEA was increased. These parameters normalized within 1 y after cessation of the vegan diet. Normalization of testosterone and DHEA levels was paralleled by a constant improvement of symptoms; full sexual function was regained 1 y after cessation of the vegan diet. This case indicates that soy product consumption is related to hypogonadism and erectile dysfunction. To the best of our knowledge, this is the first report of a combination of decreased free testosterone and increased DHEA blood concentrations after consuming a soy-rich diet. Hence, this case emphasizes the impact of isoflavones in the regulation of sex hormones and associated physical alterations.
先前的研究主要集中在大豆及其活性成分异黄酮的有益作用上。例如，大豆的摄入与降低心血管疾病和乳腺癌风险有关。然而，由于其类雌激素特性而导致异黄酮产生不良反应的报告数量有所增加。我们介绍了一个 19 岁的 1 型糖尿病患者，但其他方面都很健康，他在素食饮食中大量摄入大豆制品后，突然出现性欲丧失和勃起功能障碍。在最初就诊时采集游离睾酮和总睾酮以及脱氢表雄酮（DHEA）的血药浓度进行检查，并在停止素食饮食后持续监测长达 2 年。游离睾酮和总睾酮的血药浓度最初降低，而 DHEA 增加。这些参数在停止素食饮食后 1 年内恢复正常。睾酮和 DHEA 水平的正常化与症状的持续改善平行；停止素食饮食 1 年后，性功能完全恢复。本病例表明，大豆制品的摄入与性腺功能减退和勃起功能障碍有关。据我们所知，这是首例报告摄入富含大豆的饮食后游离睾酮降低和 DHEA 血药浓度升高的病例。因此，本病例强调了异黄酮在调节性激素和相关身体变化方面的作用。
