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系统评价和荟萃分析大豆对甲状腺功能的影响。

Systematic Review and Meta-analysis on the Effect of Soy on Thyroid Function.

机构信息

Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK.

Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Sci Rep. 2019 Mar 8;9(1):3964. doi: 10.1038/s41598-019-40647-x.

Abstract

Soy foods have had an important dietary role in Asian countries for centuries, and in recent years they have become increasingly popular in Western countries as a result of their suggested health benefits. Nevertheless, there are some concerns that soy can have a negative effect on thyroid function and can alter the levels of thyroid hormones. The aim of this systematic review was to investigate the link between soy or soy product consumption and thyroid function via the measurement of thyroid hormone levels. A systematic review and meta-analysis was undertaken on all randomised controlled trials of studies including soy as an intervention and where free triiodothyronine (fT3), free thyroxine (fT4) and thyroid stimulating hormone (TSH) was measured. The search included PubMed, MEDLINE, EMBASE, Cochrane and sources for the grey literature. Quantitative data synthesis was performed using a random-effects model, with standardized mean difference (SMD) and 95% confidence interval as summary statistics. A total of 18 articles were suitable for review. The meta-analysis showed no significant changes in fT3 (WMD: 0.027 pmol/L, 95% CI: -0.052, 0.107, p = 0.499; I: 55.58%), fT4 (WMD: -0.003 pmol/L, 95% CI: -0.018, 0.011, p = 0.656; I: 87.58%) while an elevation in TSH levels was observed (WMD: 0.248 mIU/L, 95% CI: 0.001, 0.494, p = 0.049; I: 80.31%) levels with soy supplementation. There was no evidence of publication bias. Soy supplementation has no effect on the thyroid hormones and only very modestly raises TSH levels, the clinical significance, if any, of the rise in TSH is unclear.

摘要

大豆食品在亚洲国家已有几个世纪的重要饮食作用,近年来,由于其被认为对健康有益,在西方国家也越来越受欢迎。然而,有人担心大豆可能对甲状腺功能产生负面影响,并改变甲状腺激素水平。本系统评价的目的是通过测量甲状腺激素水平来研究大豆或大豆制品的摄入与甲状腺功能之间的关系。对所有包含大豆作为干预措施且测量游离三碘甲状腺原氨酸(fT3)、游离甲状腺素(fT4)和促甲状腺激素(TSH)的随机对照试验进行了系统评价和荟萃分析。检索包括 PubMed、MEDLINE、EMBASE、Cochrane 和灰色文献来源。使用随机效应模型进行定量数据综合,以标准化均数差(SMD)和 95%置信区间作为汇总统计量。共有 18 篇文章适合进行综述。荟萃分析显示,fT3 水平无显著变化(WMD:0.027 pmol/L,95%CI:-0.052,0.107,p=0.499;I:55.58%),fT4 水平也无显著变化(WMD:-0.003 pmol/L,95%CI:-0.018,0.011,p=0.656;I:87.58%),但 TSH 水平升高(WMD:0.248 mIU/L,95%CI:0.001,0.494,p=0.049;I:80.31%)。没有发表偏倚的证据。大豆补充剂对甲状腺激素没有影响,仅能适度升高 TSH 水平,TSH 升高的临床意义(如果有的话)尚不清楚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a91f/6408586/39367c737034/41598_2019_40647_Fig1_HTML.jpg

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