Inhibition of soy isoflavone intake on bone loss in menopausal women: evaluated by meta-analysis of randomized controlled trials

目的 采用meta分析方法研究大豆异黄酮摄入对骨丢失影响.方法 搜索MEDLINE、中国期刊网等中外数据库,收集了考察大豆异黄酮摄入与尿脱氧吡啶酚(Dpyr)、血清骨特异性碱性磷酸酶(BAP)、脊椎骨骨密度(SBMD)相关的随机对照研究,并对符合纳入标准的研究进行了meta分析.结果 纳入18篇研究,978个研究对象.与对照组相比,大豆异黄酮组尿Dpyr的浓度显著降低,其效应值为-2.08 nmol/mmol(95%CI:-3.82～0.34);血清BAP的浓度显著升高了1.48μg/L(95%CI:0.22,2.75),大豆异黄酮摄入组SBMD显著增加了20.6mg/cm~2(95% CI:4.5～36.6).当大豆异黄酮摄入量大于90mg/d或持续时间6个月时,对SBMD的影响效应值分别为28.5 mg/cm~2(95% CI:8.4～48.6)和27 mg/cm~2(95% CI:8.3～45.8).结论 大豆异黄酮干预能显著地抑制骨吸收和刺激骨形成,从而改善骨质量,防止妇女骨质疏松的发生.Objective To clarify the effects of soy isoflavone intake on bone loss, meta-analysis of randomized controlled trials (RCTs) was performed. Methods RCTs that observed the effects of soy isoflavone intake on urinary deoxypyridinoline (Dpyr), serum bone-specific alkaline phosphatase (BAP), and spine bone mineral density (SBMD) were searched by MEDLINE, CNKI, and so on. Meta-analysis for the RCTs selected in the analysis was performed. Results Eighteen studies with a total of 978 subjects were selected for the analysis. The urinary Dpyr concentration in subjects who consumed isoflavones significantly decreased by -2.08nmol/mmol (95 % CI : -3.82 -0.34) in comparison to that in subjects who did not consume isoflavones. However, isoflavone intake significantly increased serum BAP by 1.48μg/L (95 % CI:0. 22-2.75). The SBMD in subjects who consumed isoflavones increased significantly by 20.6mg/ cm~2 (95 % CI:4.5 -36.6). Subjects who consumed isoflavone more than 90mg/day and or 6 months increased SBMD as 28.5mg/cm~2(95% CI:8.4 -48.6) and 27mg/cm~2 (95% CI:8.3 -45.8), respectively. Conclusion It was suggested that the bone loss in menopausal women attenuated by isoflavone intervention could be associated with inhibition of bone resorption and stimulation of bone formation.国家自然科学基金PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)05546-5513