Centre of Research and Promotion of Women's Health, School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
Am J Clin Nutr. 2011 May;93(5):1092-101. doi: 10.3945/ajcn.110.007187. Epub 2011 Mar 2.
Evidence from animal and observational studies has supported the beneficial effects of soy intake on glycemic control, but intervention studies in humans have generated mixed results and have not been systematically examined.
We aimed to quantitatively evaluate the effects of soy intake on measures of glycemic control.
We conducted a structured electronic search of PubMed, EMBASE, the Cochrane Library, and the China National Knowledge Infrastructure (updated to March 2010) databases for randomized controlled trials that described the effectiveness of different soy regimes on measures of glycemic control [homeostatic model assessment of insulin resistance (HOMA-IR) and fasting glucose and insulin, glycated hemoglobin (Hb A(1c)), and 2-h glucose and insulin concentrations]. Data on participants, interventions, outcomes, and potential effect modifiers were extracted independently. Weighted mean effect sizes were calculated for net changes by using fixed-effects or random-effects models. We performed prespecified subgroup analyses to explore the influence of covariates on net changes of fasting glucose and insulin concentrations.
Twenty-four trials with a total of 1518 subjects were included in the meta-analysis. Soy consumption did not significantly affect measures of glycemic control. The mean (95% CI) difference was -0.69 mg/dL (-1.65, 0.27 mg/dL) for fasting glucose concentrations in the fixed-effects model (P = 0.16) and -0.18 mg/dL (-0.70, 0.34 mg/dL) for fasting insulin concentrations in the random-effects model (P = 0.50). Significant heterogeneity was noted in the results of fasting insulin concentrations and HOMA-IR.
There was not a significant overall effect of soy intake on improvements of fasting glucose and insulin concentrations; however, a favorable change in fasting glucose concentrations was observed in studies that used whole soy foods or a soy diet in the subgroup analysis. Evidence for other glycemic variables such as Hb A(1c) and 2-h postchallenge glucose and insulin concentrations was limited because of the small number of trials.
动物和观察性研究的证据支持大豆摄入对血糖控制的有益影响，但人体干预研究得出的结果喜忧参半，且尚未进行系统的评估。
我们旨在定量评估大豆摄入对血糖控制指标的影响。
我们对 PubMed、EMBASE、Cochrane 图书馆和中国国家知识基础设施（更新至 2010 年 3 月）数据库进行了结构化电子检索，以查找描述不同大豆方案对血糖控制指标（稳态模型评估的胰岛素抵抗（HOMA-IR）和空腹血糖及胰岛素、糖化血红蛋白（Hb A1c）以及 2 小时血糖和胰岛素浓度）的有效性的随机对照试验。我们独立提取了参与者、干预措施、结局和潜在的效应修饰因素的数据。使用固定效应或随机效应模型计算净变化的加权均数效应大小。我们进行了预设的亚组分析，以探索协变量对空腹血糖和胰岛素浓度净变化的影响。
共有 24 项试验，总计 1518 例受试者纳入荟萃分析。大豆的摄入并未显著影响血糖控制指标。固定效应模型下空腹血糖浓度的平均（95%CI）差值为-0.69mg/dL（-1.65，0.27mg/dL）（P=0.16），随机效应模型下空腹胰岛素浓度的平均差值为-0.18mg/dL（-0.70，0.34mg/dL）（P=0.50）。空腹胰岛素浓度和 HOMA-IR 的结果存在显著的异质性。
大豆摄入对空腹血糖和胰岛素浓度的改善没有显著的总体影响；但是，在亚组分析中，使用全大豆食品或大豆饮食的研究观察到空腹血糖浓度有有利的变化。由于试验数量较少，Hb A1c 以及 2 小时餐后血糖和胰岛素浓度等其他血糖变量的证据有限。
