Exposure to isoflavone-containing soy products and endothelial function: a Bayesian meta-analysis of randomized controlled trials

Nutr Metab Cardiovasc Dis. 2012 Mar;22(3):182-91. doi: 10.1016/j.numecd.2010.05.007. Epub 2010 Aug 14.

Abstract

Background and aims: To determine whether and to what degree exposure to isoflavone-containing soy products affects EF. Endothelial dysfunction has been identified as an independent coronary heart disease risk factor and a strong predictor of long-term cardiovascular morbidity and mortality. Data on the effects of exposure to isoflavone-containing soy products on EF are conflicting.

Methods and results: A comprehensive literature search was conducted using the PUBMED database (National Library of Medicine, Bethesda, MD) inclusively through August 21, 2009 on RCTs using the keywords: soy, isoflavone, phytoestrogen, EF, flow mediated vasodilation, and FMD. A Bayesian meta-analysis was conducted to provide a comprehensive account of the effect of isoflavone-containing soy products on EF, as measured by FMD. A total of 17 RCTs were selected as having sufficient data for study inclusion. The overall mean absolute change in FMD (95% Bayesian CI) for isoflavone-containing soy product interventions was 1.15% (-0.52, 2.75). When the effects of separate interventions were considered, the treatment effect for isolated isoflavones was 1.98% (0.07, 3.97) compared to 0.72% (-1.39, 2.90) for isoflavone-containing soy protein. The models were not improved when considering study-specific effects such as cuff measurement location, prescribed dietary modification, and impaired baseline FMD.

Conclusions: Cumulative evidence from the RCTs included in this meta-analysis indicates that exposure to soy isoflavones can modestly, but significantly, improve EF as measured by FMD. Therefore, exposure to isoflavone supplements may beneficially influence vascular health.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Aged
  • Bayes Theorem*
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / physiopathology
  • Cardiovascular Diseases / prevention & control*
  • Diet*
  • Endothelium, Vascular / drug effects*
  • Endothelium, Vascular / physiopathology
  • Evidence-Based Medicine
  • Female
  • Humans
  • Isoflavones / administration & dosage*
  • Isoflavones / analysis
  • Male
  • Middle Aged
  • Randomized Controlled Trials as Topic
  • Soy Foods* / analysis
  • Treatment Outcome
  • Vasodilation / drug effects*
  • Vasodilator Agents / administration & dosage*
  • Vasodilator Agents / analysis

Substances

  • Isoflavones
  • Vasodilator Agents