Preventive effects of phytoestrogens against postmenopausal osteoporosis as compared to the available therapeutic choices: An overview.
Preventive effects of phytoestrogens against postmenopausal osteoporosis as compared to the available therapeutic choices: An overview.
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DOI：
10.4103/0976-9668.92322
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发表时间：
2011-07
期刊：
影响因子：
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通讯作者：
Qureshi S
中科院分区：
文献类型：
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作者：
Al-Anazi AF;Qureshi VF;Javaid K;Qureshi S
雌激素缺乏是绝经后妇女骨质疏松症的主要危险因素。虽然激素替代疗法（HRT）已被广泛用于补偿骨丢失，但该过程伴随着严重的不良反应。因此，有一个在生产新的合成产品，以抵御更年期相关的骨质疏松症的影响的推动。截至今天，有几种处方产品可用于治疗绝经后骨质疏松症;其中大多数是雌激素制剂和组合产品。然而，鉴于这些产品缺乏效果和/或毒性，大多数绝经后妇女现在对高度宣传的天然产品着迷。这是普遍共识的一个分支，即这些产品更有效，没有任何不良影响。近年来，植物中的某些植物源性天然产物，主要是植物雌激素（雌甾酮、木脂素、香豆烷、芪类、类黄酮）和许多新的雌激素样化合物已被广泛用于预防绝经相关的骨矿物质密度（BMD）减少。虽然，一些论文发表了更年期相关的一般症状，性功能障碍，心血管疾病，阿尔茨海默氏病，糖尿病，结肠癌和乳腺癌，有伴随骨质疏松症及其治疗的文献匮乏。鉴于对合成激素和药物的争议以及主要患者人群向天然药物的漂移，发现值得研究这些药物是否适合用于治疗绝经后骨质疏松症。本文拟对绝经后骨质疏松症的流行病学、激素和合成药物治疗绝经后骨质疏松症的方法及其缺点和副作用、植物雌激素预防和治疗绝经后骨质疏松症的方法及其缺点和毒性进行综述。很明显，这两种治疗方法都是有用的，都有副作用，但植物产品是不科学的，因此不建议使用，直到进行更多的研究，以确保收益明显超过风险，除了食品和药物管理局的认可。
Estrogen deficiency is a major risk factor for osteoporosis in postmenopausal women. Although hormone replacement therapy (HRT) has been rampantly used to recompense for the bone loss, but the procedure is coupled with severe adverse effects. Hence, there is a boost in the production of newer synthetic products to ward off the effects of menopause-related osteoporosis. As of today, there are several prescription products available for the treatment of postmenopause osteoporosis; most of these are estrogenic agents and combination products. Nevertheless, in view of the lack of effect and/or toxicity of these products, majority of the postmenopausal women are now fascinated by highly publicized natural products. This is an offshoot of the generalized consensus that these products are more effective and free from any adverse effects. Recently, certain plant-derived natural products, mostly phytoestrogens (isoflavones, lignans, coumestanes, stilbenes, flavonoids) and many more novel estrogen-like compounds in plants have been immensely used to prevent menopause-related depletion in bone mineral density (BMD). Although, a number of papers are published on menopause-related general symptoms, sexual dysfunction, cardiovascular diseases, Alzheimer's disease, diabetes, colon, and breast cancers, there is paucity of literature on the accompanying osteoporosis and its treatment. In view of the controversies on synthetic hormones and drugs and drift of a major population of patients toward natural drugs, it was found worthwhile to investigate if these drugs are suitable to be used in the treatment of postmenopausal osteoporosis. Preparation of this paper is an attempt to review the (a) epidemiology of postmenopausal osteoporosis, (b) treatment modalities of postmenopausal osteoporosis by hormones and synthetic drugs and the associated drawbacks and adverse effects, and (c) prevention and treatment of postmenopausal osteoporosis by phytoestrogens, their drawbacks and toxicity. It is apparent that both the categories of treatment are useful and both have adverse effects, but the plant products are nonscientific and hence are not advised to be used till more studies are undertaken to ensure that the benefits clearly outweigh the risk, in addition to recognition by Food and Drug Administration.