CVD Mechanisms Associated with Phytoestrogens Use

雌激素替代疗法对心脏病的危险因素有有益的影响。然而，很大比例的绝经后妇女不符合治疗方案。植物雌激素是天然存在的化合物，存在于植物和豆制品中，具有类似serm的作用。尽管许多研究表明雌激素对脂质和脂蛋白有有益作用，但很少有人研究植物雌激素可能发挥心脏保护作用的其他机制。潜在的机制包括同型半胱氨酸代谢的改变，炎症活性标志物如白细胞介素-6 （IL- 6）和c反应蛋白（CRP）的抑制，粘附分子如e -选择素的减少以及肥胖和体脂的减少。在大豆健康效应（SHE）研究中，利用新的实验室分析和先前收集的210名绝经后妇女的数据，本研究将检查除脂质外，植物雌激素可能降低心脏病风险的潜在机制。SHE研究是一项随机、双盲、安慰剂对照研究，旨在确定膳食补充剂植物雌激素（特别是染料木黄酮）对心脏病风险因素、骨密度和社会心理结局的可接受性和益处。在两年的时间里，通过筛查、基线和定期随访收集数据。要求资金用于检测冷冻血清中的同型半胱氨酸、IL-6、CRP和e -选择素；并根据提出的假设分析SHE研究访问的数据。将在协变量调整和分层前后对治疗组和安慰剂组进行横断面和纵向比较。预计接受植物雌激素治疗的妇女在2年内会有较低的同型半胱氨酸、IL-6、CRP、e -选择素，并减少肥胖和脂肪量；肥胖和体重增加与同型半胱氨酸、IL-6、CRP和E-选择素呈正相关；植物雌激素的使用与肥胖的变化会对同型半胱氨酸、IL-6、CRP和e -选择素产生交互作用。考虑到女性绝经后可能会度过三分之一的生命，了解植物雌激素是否以及如何改变心血管疾病机制是很重要的。

Estrogen replacement therapy has beneficial effects on heart disease risk factors. However, a large proportion of postmenopausal women are not compliant with therapeutic regimens. Phytoestrogens are naturally occurring compounds found in plants and soy products that have SERM-like effects. Although numerous studies have shown a beneficial effect of estrogens on lipids and lipoproteins, few examined other mechanisms by which phytoestrogens might exert a cardioprotective effect. Potential mechanisms include changes in homocysteine metabolism, inhibition in markers of inflammatory activity including interleukin-6 (IL- 6) and C-reactive protein (CRP), decreases in adhesion molecules such as E-selectin and decreases in obesity and body fat. Using new laboratory assays and previously collected data from 210 postmenopausal women in the Soy Health Effects (SHE) Study, this study will examine potential mechanisms other than lipids, by which phytoestrogens may reduce the risk of heart disease. The SHE Study is a randomized, double blind, placebo controlled study designed to determine the acceptability and benefits of a dietary supplement of phytoestrogen, specifically, genistein, on heart disease risk factors, bone density and psychosocial outcomes. Data was collected at screening, baseline, and periodic follow-ups over the course of two years. Funds are requested to assay homocysteine, IL-6, CRP, and E-selectin in frozen sera; and analyze data from SHE Study visits as related to the proposed hypotheses. Cross-sectional and longitudinal comparisons of treatment and placebo groups will be performed before and after adjustment and stratification for covariates. It is expected that women treated with phytoestrogens will have lower homocysteine, IL-6, CRP, E-selectin, and decreased obesity and fat mass over 2 years; that obesity and weight gain will be positively associated with homocysteine, IL-6, CRP, and E- selectin; and that there will be an interactive effect of phytoestrogen use and change in obesity on homocysteine, IL-6, CRP and E-selectin. Given that women can expect to live one-third of their lives after menopause, it is important to know whether and how phytoestrogens may modify cardiovascular disease mechanisms.