Soy isoflavones interact with calcium and contribute to blood pressure homeostasis in women: a randomized, double-blind, placebo controlled trial
Soy isoflavones interact with calcium and contribute to blood pressure homeostasis in women: a randomized, double-blind, placebo controlled trial
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DOI：
10.1007/s00394-019-02085-3
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发表时间：
2019-09
影响因子：
5
通讯作者：
Lee-Jane W. Lu;Nai-Wei Chen;F. Nayeem;M. Nagamani;K. Anderson
中科院分区：
文献类型：
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作者：
Lee-Jane W. Lu;Nai-Wei Chen;F. Nayeem;M. Nagamani;K. Anderson
在随机试验中，雌激素和钙调节血管健康，但引起不良心血管事件。目的探讨植物雌激素大豆异黄酮是否调节钙对血压的生理效应。设计一项双盲随机研究，99名绝经前妇女服用136.6 mg异黄酮(相当于苷元)，98名服用安慰剂，每周服用5天，为期2年。治疗前后重复测定血压、血钙和尿中大豆苷元(DE)和染料木素(GE)的排泄量。结果异黄酮类化合物不影响每次摄入剂量分配的血压(即意向治疗，n= 197)，但显著影响每测量的尿异黄酮量的血压(即按方案分析，n= 166)。异黄酮反转地调节钙对收缩压的影响(相互作用项β估计：DE的− 3.1，GE的− 12.86，ALL P<； 0.05)，并在控制钙后降低舒张压(β估计：DE的− 0.84，GE的− 2.82，ALL P<； 0.05)。在血钙为10.61 mg/dL和8.0 mg/dL时，最大异黄酮排泄量与无异黄酮排泄量之间的净干预效应分别为SBP的− 17.7和+ 13.8 mm Hg变化，DBP降低约2.6 mm Hg。结论异黄酮类调节钙的生理效应使SBP趋于正常化，且当钙浓度处于生理正常值的上下限时，这种作用最为显著。异黄酮会降低舒张压，而不依赖于钙水平。还需要进一步的研究来评估这种新的微量营养素效应对血压稳态和心血管健康的影响。试验登记www.Clinicaltrials.gov标识符：NCT00204490。
BackgroundEstrogens and calcium regulate vascular health but caused adverse cardiovascular events in randomized trials.ObjectivesWhether phytoestrogenic soy isoflavones modulate the physiological effects of calcium on blood pressure was explored.DesignA double-blind, randomized study assigned 99 premenopausal women to 136.6 mg isoflavones (as aglycone equivalents) and 98 to placebo for 5 days per week for up to 2 years. Blood pressure, serum calcium and urinary excretion of daidzein (DE) and genistein (GE) were measured repeatedly before and during treatment.ResultsIsoflavones did not affect blood pressure per intake dose assignment (i.e. intention-to-treat,n= 197), but significantly affected blood pressure per measured urinary excretion of isoflavones (i.e. per protocol analysis,n= 166). Isoflavones inversely moderated calcium effects on systolic blood pressure (SBP) (interaction termβ-estimates: − 3.1 for DE, − 12.86 for GE, allP< 0.05), and decreased diastolic blood pressure (DBP) (β-estimates: − 0.84 for DE, − 2.82 for GE, allP< 0.05) after controlling for calcium. The net intervention effects between the maximum and no isoflavone excretion were − 17.7 and + 13.8 mmHg changes of SBP, respectively, at serum calcium of 10.61 and 8.0 mg/dL, and about 2.6 mmHg decrease of DBP.ConclusionsModeration by isoflavones of the physiological effect of calcium tends to normalize SBP, and this effect is most significant when calcium concentrations are at the upper and lower limits of the physiological norm. Isoflavones decrease DBP independent of calcium levels. Further studies are needed to assess the impact of this novel micronutrient effect on blood pressure homeostasis and cardiovascular health.Trial registrationwww.clinicaltrials.gov identifier: NCT00204490.