SOY PHYTOESTROGENS AND METABOLIC CARDIOVASCULAR RISK

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。更年期与心血管疾病的风险增加有关。其中一些风险的增加可能是由于卵巢激素分泌减少导致胰岛素敏感性的恶化。如果卵巢功能的丧失降低了胰岛素敏感性，我们可以假设激素替代疗法（HRT）可以改善绝经后妇女的胰岛素敏感性。然而，与这一假设相反，在一项随机对照试验中，我们发现雌激素/黄体酮联合激素替代疗法会恶化胰岛素敏感性。无黄体酮替代雌激素的研究普遍显示对胰岛素敏感性有益。因此，仅替代雌激素可能对增加绝经后妇女的胰岛素敏感性有有益作用。自从妇女健康倡议详细介绍了雌激素/黄体酮联合激素替代疗法的长期心血管风险以来，绝经后妇女对传统激素替代疗法的替代品越来越感兴趣。其中一种替代品是天然存在的大豆植物雌激素。据我们所知，没有关于大豆植物雌激素补充对葡萄糖处理、胰岛素分泌和身体成分的影响的人类数据，作为预防肥胖、非糖尿病绝经后妇女心血管疾病的代谢危险因素。我们建议研究补充Revial Soy（每天16克大豆蛋白和120毫克大豆异黄酮表示为糖苷元）对这些参数的影响。本研究还将解释大豆植物雌激素对人体葡萄糖和胰岛素代谢影响的生理机制。

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.