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大豆异黄酮补充对血浆脂蛋白(a)浓度的影响:荟萃分析。

Effect of soy isoflavone supplementation on plasma lipoprotein(a) concentrations: A meta-analysis.

机构信息

Biomedical Research Unit, Mexican Social Security Institute, Durango, Mexico.

Weill Cornell Medical College, New York, NY, USA.

出版信息

J Clin Lipidol. 2018 Jan-Feb;12(1):16-24. doi: 10.1016/j.jacl.2017.10.004. Epub 2017 Oct 17.

Abstract

BACKGROUND

Soy supplementation has been shown to reduce total and low-density lipoprotein cholesterol, while increasing high-density lipoprotein cholesterol. However, contradictory effects of soy isoflavone supplementation on lipoprotein(a) [Lp(a)] have been reported suggesting the need for a meta-analysis to be undertaken.

OBJECTIVE

The aim of the study was to investigate the impact of supplementation with soy isoflavones on plasma Lp(a) levels through a systematic review and meta-analysis of eligible randomized placebo-controlled trials.

METHODS

The search included PubMed-Medline, Scopus, ISI Web of Knowledge, and Google Scholar databases (by March 26, 2017), and quality of studies was evaluated according to Cochrane criteria. Quantitative data synthesis was performed using a random-effects model, with standardized mean difference and 95% confidence interval as summary statistics. Meta-regression and leave-one-out sensitivity analysis were performed to assess the modifiers of treatment response.

RESULTS

Ten eligible studies comprising 11 treatment arms with 973 subjects were selected for the meta-analysis. Meta-analysis did not suggest any significant alteration of plasma Lp(a) levels after supplementation with soy isoflavones (standardized mean difference: 0.08, 95% confidence interval: -0.05, 0.20, P = .228). The effect size was robust in the leave-one-out sensitivity analysis. In meta-regression analysis, neither dose nor duration of supplementation with soy isoflavones was significantly associated with the effect size.

CONCLUSION

This meta-analysis of the 10 available randomized placebo-controlled trials revealed no significant effect of soy isoflavones treatment on plasma Lp(a) concentrations.

摘要

背景

大豆补充剂已被证明可降低总胆固醇和低密度脂蛋白胆固醇,同时增加高密度脂蛋白胆固醇。然而,大豆异黄酮补充剂对脂蛋白(a)[Lp(a)]的影响存在矛盾,这表明需要进行荟萃分析。

目的

本研究旨在通过对合格的随机安慰剂对照试验进行系统评价和荟萃分析,调查大豆异黄酮补充对血浆 Lp(a)水平的影响。

方法

搜索包括 PubMed-Medline、Scopus、ISI Web of Knowledge 和 Google Scholar 数据库(截至 2017 年 3 月 26 日),并根据 Cochrane 标准评估研究质量。使用随机效应模型进行定量数据合成,标准化均数差和 95%置信区间作为汇总统计量。进行了荟萃回归和逐一剔除敏感性分析,以评估治疗反应的修饰剂。

结果

选择了 10 项符合条件的研究,包括 11 个治疗组,共 973 名受试者,进行荟萃分析。荟萃分析表明,大豆异黄酮补充后血浆 Lp(a)水平没有明显变化(标准化均数差:0.08,95%置信区间:-0.05,0.20,P = 0.228)。逐一剔除敏感性分析中的效应量是稳健的。在荟萃回归分析中,大豆异黄酮补充的剂量和持续时间与效应大小均无显著相关性。

结论

本荟萃分析对 10 项现有随机安慰剂对照试验进行分析,未发现大豆异黄酮治疗对血浆 Lp(a)浓度有显著影响。

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