Phytoestrogens and cardiovascular disease.
Phytoestrogens and cardiovascular disease.
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DOI：
10.1258/136218006777525776
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发表时间：
2006-06-01
期刊：
影响因子：
--
通讯作者：
Hooper, Lee
中科院分区：
文献类型：
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作者：
Cassidy, Aedin;Hooper, Lee
研究最广泛的一类植物雌激素异黄酮存在于大豆和其他豆类中。六项系统性综述评估了大豆异黄酮对脂质水平的影响，并建议补充含有大豆异黄酮的大豆分离蛋白（ISP）的饮食可将低密度脂蛋白（LDL）胆固醇降低约0.15 mmol/L，但对甘油三酯或高密度脂蛋白（HDL）胆固醇没有明显影响。然而，没有评论表明纯化的大豆异黄酮或不含异黄酮的大豆蛋白（其中异黄酮已通过酒精洗涤除去）具有统计学显著的效果。目前还不清楚哪些是大豆的活性成分。它们可以包括未被醇洗变性的大豆蛋白、完整大豆基质内的异黄酮的相互作用或在醇提取级分中除去的其他化合物。男性总胆固醇的降低程度可能大于绝经后女性。几乎没有证据表明，大豆的有效性与基线血脂水平，或大豆蛋白或大豆蛋白的摄入量有关。然而，甘油三酯的变化可能与基线水平相关。虽然没有证据表明植物雌激素对血压，动脉顺应性或LDL胆固醇氧化的有益作用，但对绝经后妇女的内皮功能和同型半胱氨酸浓度可能有有益作用。几乎没有迹象表明大豆或大豆酮在生理剂量下会产生不良影响，尽管服用大豆维生素补充剂的人确实出现了更高水平的胃肠和月经不适。目前还没有关于植物雌激素对死亡率或心血管事件影响的公开试验，因此目前的研究依赖于上述风险的生物标志物。大多数证据与大豆异黄酮有关，但也有一些关于木脂素的证据。需要进一步的可靠研究来评估全大豆食品对心血管结局的影响。
The most extensively studied class of phytoestrogens, isoflavones, occur in soybeans and other legumes. Six systematic reviews have assessed the effects of soy isoflavones on lipid levels, and suggested that a diet supplemented with soy protein isolate (ISP) containing isoflavones reduces low-density lipoprotein (LDL) cholesterol by around 0.15 mmol/L, but without clear effects on triglycerides or high-density lipoprotein (HDL) cholesterol. However, no review has suggested that purified soy isoflavones or soy protein without isoflavones (where the isoflavones have been removed by an alcohol wash) have statistically significant effects. It remains unclear which are the active components of soy. They may include soy protein which has not been denatured by alcohol wash, interaction of isoflavones within the intact soy matrix, or other compounds removed in the alcohol-extracted fraction. The reduction in total cholesterol may be greater in men than in postmenopausal women. There is little evidence that the effectiveness of soy varies with baseline serum lipid levels, or the amount of isoflavone or soy protein consumed. However, changes in triglycerides may be related to baseline levels. While there is no evidence of beneficial effects of phytoestrogens on blood pressure, arterial compliance or oxidation of LDL cholesterol, there may be beneficial effects on endothelial function in postmenopausal women, and on homocysteine concentrations. There is little suggestion of adverse effects of soy or isoflavones at physiological doses, although those taking soy isoflavone supplements do appear to have higher levels of gastro intestinal and menstrual complaints. There have been no published trials on the effects of phytoestrogens on mortality or cardiovascular events, so studies currently rely on the above bio markers of risk. Most evidence relates to soy isoflavones, but there is some evidence for lignans. Further robust studies assessing the effects of whole soy foods on cardiovascular outcomes are needed.