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异黄酮干预对围绝经期和绝经后女性骨代谢的影响:随机对照试验荟萃分析的伞状综述

Effects of Isoflavone Interventions on Bone Metabolism in Perimenopausal and Postmenopausal Women: An Umbrella Review of Meta-Analyses of Randomized Controlled Trials.

作者信息

Zhuge Lifang, Chen Lanlan, Pan Weiping

机构信息

Department of Gynecology, Beilun District People's Hospital, Ningbo, P.R. China.

Department of Gynecology, Maternal and Child Health Hospital, Jinhua, P.R. China.

出版信息

Endocr Pract. 2025 Feb;31(2):226-235. doi: 10.1016/j.eprac.2024.08.009. Epub 2024 Aug 28.

DOI:10.1016/j.eprac.2024.08.009
PMID:39214463
Abstract

OBJECTIVE

Previous meta-analyses have investigated the effects of isoflavones on bone metabolism in perimenopausal or postmenopausal women. However, there were still conflicting results. Thereby, this umbrella review assessed the existing meta-analysis evidence of the effects of isoflavone interventions on bone metabolism in perimenopausal and postmenopausal women.

METHODS

This study was conducted following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. From the inception until August 24, 2023, PubMed, Embase, Cochrane, and Web of Science databases were searched to identify meta-analyses of randomized controlled trials. The outcomes included bone mineral densities (BMDs), and bone turnover markers of osteocalcin, bone-specific alkaline phosphatase, pyridinoline, deoxypyridinoline, Procollagen Type 1 N-Terminal Propeptide, and C-telopeptide of Type 1 Collagen. The random-effects model was used to recalculate the extracted effect sizes. Mean difference (MD) was used as a summary effect measure.

RESULTS

Ten meta-analyses of randomized controlled trials were included. The isoflavone intervention was associated with increased BMDs in lumbar spine (MD: 11.50 mg/cm, 95% confidence interval (CI): 6.46 to 16.55), femoral neck (MD: 2.03%, 95% CI: 0.57 to 3.50), and top hip (MD: 0.31%, 95% CI: 0.03 to 0.59) in perimenopausal and postmenopausal women.

CONCLUSION

Our findings indicate that isoflavone interventions have the potential to improve BMD at different bone sites, including the lumbar spine, femoral neck, and total hip in perimenopausal and postmenopausal women. Isoflavone may be considered a complementary option in the bone loss of perimenopausal and postmenopausal women.

摘要

目的

既往的荟萃分析研究了异黄酮对围绝经期或绝经后女性骨代谢的影响。然而,结果仍存在矛盾。因此,本伞状综述评估了异黄酮干预对围绝经期和绝经后女性骨代谢影响的现有荟萃分析证据。

方法

本研究按照系统评价和荟萃分析的首选报告项目指南进行。从开始到2023年8月24日,检索了PubMed、Embase、Cochrane和Web of Science数据库,以识别随机对照试验的荟萃分析。结局指标包括骨密度(BMD)以及骨钙素、骨特异性碱性磷酸酶、吡啶啉、脱氧吡啶啉、I型前胶原N端前肽和I型胶原C末端肽等骨转换标志物。采用随机效应模型重新计算提取的效应量。平均差(MD)用作汇总效应量指标。

结果

纳入了10项随机对照试验的荟萃分析。异黄酮干预与围绝经期和绝经后女性腰椎(MD:11.50mg/cm,95%置信区间(CI):6.46至16.55)、股骨颈(MD:2.03%,95%CI:0.57至3.50)和髋部上方(MD:0.31%,95%CI:0.03至0.59)的骨密度增加相关。

结论

我们的研究结果表明,异黄酮干预有可能改善围绝经期和绝经后女性不同骨骼部位的骨密度,包括腰椎、股骨颈和全髋。异黄酮可被视为围绝经期和绝经后女性骨质流失的一种补充选择。

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