SOY PHYTOESTROGENS AND METABOLIC CARDIOVASCULAR RISK

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Menopause is associated with an increased risk of cardiovascular disease. Some of this increased risk may be due to worsening insulin sensitivity that occurs with declining ovarian hormone production. If the loss of ovarian function reduces insulin sensitivity, it is plausible to hypothesize that hormone replacement therapy (HRT) would improve insulin sensitivity in postmenopausal women. Contrary to this hypothesis, however, in a randomized, controlled trial, we found that combined estrogen/progestin hormone replacement therapy worsened insulin sensitivity. Studies of estrogen replacement without a progestin have generally shown a beneficial effect on insulin sensitivity. Thus, replacement of estrogen only may have beneficial effects to increase insulin sensitivity in postmenopausal women. Since the publication of the Women's Health Initiative detailing the long-term cardiovascular risks of combined estrogen/progestin HRT, postmenopausal women have become more interested in alternatives to traditional HRT. One such alternative is naturally-occurring soy phytoestrogens. To our knowledge, no human data are available with regard to the effect of soy phytoestrogen supplementation on glucose disposal, insulin secretion, and body composition as metabolic risk factors for cardiovascular disease prevention in obese, non-diabetic postmenopausal women. We propose to examine the effect of supplementation with Revial Soy (16 grams of soy protein and 120 mg of soy isoflavones expressed as aglycones, daily) on these parameters. This study will also explain physiologic mechanisms for the effect of soy phytoestrogens on glucose and insulin metabolism in humans.