CVD Mechanisms Associated with Phytoestrogens Use

雌激素替代疗法对心脏病危险因素有有益的影响。 然而，很大一部分绝经后妇女不依从治疗方案。植物雌激素是在植物和大豆产品中发现的天然化合物，具有类似SERM的作用。 虽然许多研究表明雌激素对脂质和脂蛋白的有益作用，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变化，炎症活性标志物（包括白细胞介素-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。使用新的实验室检测和之前从大豆健康影响（SHE）研究中收集的210名绝经后妇女的数据，这项研究将研究除脂质以外的潜在机制，植物雌激素可以降低心脏病的风险。SHE研究是一项随机、双盲、安慰剂对照研究，旨在确定植物雌激素（特别是染料木黄酮）膳食补充剂对心脏病风险因素、骨密度和心理社会结果的可接受性和益处。 在筛选、基线和两年的定期随访时收集数据。 要求提供资金，以测定冷冻血清中的同型半胱氨酸、IL-6、CRP和E-选择素;并分析与拟议假设相关的SHE研究访视数据。 将在调整和分层协变量前后对治疗组和安慰剂组进行横断面和纵向比较。预计用植物雌激素治疗的妇女在2年内将具有较低的高半胱氨酸、IL-6、CRP、E-选择素，以及减少的肥胖和脂肪量;肥胖和体重增加将与高半胱氨酸、IL-6、CRP和E-选择素正相关;并且植物雌激素的使用和肥胖的变化对高半胱氨酸、IL-6、CRP和E-选择素将具有交互作用。考虑到女性在绝经后的寿命只有三分之一，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.