Soy isoflavones and bone mineral density in perimenopausal and postmenopausal western women: A systematic review and meta-analysis of randomized controlled trials

Elena Ricci, Sonia Cipriani, Francesca Chiaffarino, Matteo Malvezzi, Fabio Parazzini

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Several randomized controlled trials (RCTs) have compared the effect of phytoestrogens (PEs) vs. placebos on bone density after menopause, with inconsistent results. Methods: We performed a systematic review to assess the overall effect of PEs on bone mineral density (BMD) in menopausal Western women. We searched for all RCTs comparing PEs with placebos conducted on perimenopausal or postmenopausal Western women, published from January 1990 to February 2010. The main outcome measure was the lumbar spine (LS) BMD. Results: We identified 17 studies on soy isoflavone (IFs) bone-sparing effects. Some studies did not report a difference between treated and untreated women, whereas others supported a significant role of IFs on slowing bone loss, although these studies suffered from an internal lack of consistency, as a positive effect emerged in some bone districts but not in others. Data on LS BMD were available in 12 studies including 1433 subjects overall. The effect of PEs on BMD (mg/cm2) was not statistically significant (mean difference 9.86?mg/cm2, 95% confidence interval [CI] -2.64-22.36) under a random-effects model. Excluding the genistein study, however, analyses of IF mixtures did not show a bone-sparing effect (0.73, 95% CI -2.79-4.25). No increasing effect emerged when dose and treatment duration were increased. Conclusions: Our review and meta-analysis suggest that IF mixtures are not effective in decreasing bone loss in perimenopausal and postmenopausal Western women. The role of isolated genistein and individual genetic capacity to metabolize IFs is still open to evaluation.

Original languageEnglish
Pages (from-to)1609-1617
Number of pages9
JournalJournal of Women's Health
Volume19
Issue number9
DOIs
Publication statusPublished - Sep 1 2010

Fingerprint

Isoflavones
Phytoestrogens
Bone Density
Meta-Analysis
Randomized Controlled Trials
Bone and Bones
Postmenopausal Osteoporosis
Genistein
Spine
Placebos
Confidence Intervals
Menopause
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{c460d459267d41a7a2bccb45787207f3,
title = "Soy isoflavones and bone mineral density in perimenopausal and postmenopausal western women: A systematic review and meta-analysis of randomized controlled trials",
abstract = "Background: Several randomized controlled trials (RCTs) have compared the effect of phytoestrogens (PEs) vs. placebos on bone density after menopause, with inconsistent results. Methods: We performed a systematic review to assess the overall effect of PEs on bone mineral density (BMD) in menopausal Western women. We searched for all RCTs comparing PEs with placebos conducted on perimenopausal or postmenopausal Western women, published from January 1990 to February 2010. The main outcome measure was the lumbar spine (LS) BMD. Results: We identified 17 studies on soy isoflavone (IFs) bone-sparing effects. Some studies did not report a difference between treated and untreated women, whereas others supported a significant role of IFs on slowing bone loss, although these studies suffered from an internal lack of consistency, as a positive effect emerged in some bone districts but not in others. Data on LS BMD were available in 12 studies including 1433 subjects overall. The effect of PEs on BMD (mg/cm2) was not statistically significant (mean difference 9.86?mg/cm2, 95{\%} confidence interval [CI] -2.64-22.36) under a random-effects model. Excluding the genistein study, however, analyses of IF mixtures did not show a bone-sparing effect (0.73, 95{\%} CI -2.79-4.25). No increasing effect emerged when dose and treatment duration were increased. Conclusions: Our review and meta-analysis suggest that IF mixtures are not effective in decreasing bone loss in perimenopausal and postmenopausal Western women. The role of isolated genistein and individual genetic capacity to metabolize IFs is still open to evaluation.",
author = "Elena Ricci and Sonia Cipriani and Francesca Chiaffarino and Matteo Malvezzi and Fabio Parazzini",
year = "2010",
month = "9",
day = "1",
doi = "10.1089/jwh.2010.2021",
language = "English",
volume = "19",
pages = "1609--1617",
journal = "Journal of Women's Health",
issn = "1540-9996",
publisher = "Mary Ann Liebert Inc.",
number = "9",

}

TY - JOUR

T1 - Soy isoflavones and bone mineral density in perimenopausal and postmenopausal western women

T2 - A systematic review and meta-analysis of randomized controlled trials

AU - Ricci, Elena

AU - Cipriani, Sonia

AU - Chiaffarino, Francesca

AU - Malvezzi, Matteo

AU - Parazzini, Fabio

PY - 2010/9/1

Y1 - 2010/9/1

N2 - Background: Several randomized controlled trials (RCTs) have compared the effect of phytoestrogens (PEs) vs. placebos on bone density after menopause, with inconsistent results. Methods: We performed a systematic review to assess the overall effect of PEs on bone mineral density (BMD) in menopausal Western women. We searched for all RCTs comparing PEs with placebos conducted on perimenopausal or postmenopausal Western women, published from January 1990 to February 2010. The main outcome measure was the lumbar spine (LS) BMD. Results: We identified 17 studies on soy isoflavone (IFs) bone-sparing effects. Some studies did not report a difference between treated and untreated women, whereas others supported a significant role of IFs on slowing bone loss, although these studies suffered from an internal lack of consistency, as a positive effect emerged in some bone districts but not in others. Data on LS BMD were available in 12 studies including 1433 subjects overall. The effect of PEs on BMD (mg/cm2) was not statistically significant (mean difference 9.86?mg/cm2, 95% confidence interval [CI] -2.64-22.36) under a random-effects model. Excluding the genistein study, however, analyses of IF mixtures did not show a bone-sparing effect (0.73, 95% CI -2.79-4.25). No increasing effect emerged when dose and treatment duration were increased. Conclusions: Our review and meta-analysis suggest that IF mixtures are not effective in decreasing bone loss in perimenopausal and postmenopausal Western women. The role of isolated genistein and individual genetic capacity to metabolize IFs is still open to evaluation.

AB - Background: Several randomized controlled trials (RCTs) have compared the effect of phytoestrogens (PEs) vs. placebos on bone density after menopause, with inconsistent results. Methods: We performed a systematic review to assess the overall effect of PEs on bone mineral density (BMD) in menopausal Western women. We searched for all RCTs comparing PEs with placebos conducted on perimenopausal or postmenopausal Western women, published from January 1990 to February 2010. The main outcome measure was the lumbar spine (LS) BMD. Results: We identified 17 studies on soy isoflavone (IFs) bone-sparing effects. Some studies did not report a difference between treated and untreated women, whereas others supported a significant role of IFs on slowing bone loss, although these studies suffered from an internal lack of consistency, as a positive effect emerged in some bone districts but not in others. Data on LS BMD were available in 12 studies including 1433 subjects overall. The effect of PEs on BMD (mg/cm2) was not statistically significant (mean difference 9.86?mg/cm2, 95% confidence interval [CI] -2.64-22.36) under a random-effects model. Excluding the genistein study, however, analyses of IF mixtures did not show a bone-sparing effect (0.73, 95% CI -2.79-4.25). No increasing effect emerged when dose and treatment duration were increased. Conclusions: Our review and meta-analysis suggest that IF mixtures are not effective in decreasing bone loss in perimenopausal and postmenopausal Western women. The role of isolated genistein and individual genetic capacity to metabolize IFs is still open to evaluation.

UR - http://www.scopus.com/inward/record.url?scp=77956360497&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77956360497&partnerID=8YFLogxK

U2 - 10.1089/jwh.2010.2021

DO - 10.1089/jwh.2010.2021

M3 - Article

C2 - 20673147

AN - SCOPUS:77956360497

VL - 19

SP - 1609

EP - 1617

JO - Journal of Women's Health

JF - Journal of Women's Health

SN - 1540-9996

IS - 9

ER -