植物雌激素对血压的影响

The effects of phytoestrogen on blood pressure and lipids in healthy volunteers

目的研究大豆饮食中所含的植物雌激素对健康人血压、血脂谱的影响。方法213名健康受试者(男性108人,绝经后女性105人),年龄50-75岁,随机、双盲接受特定大豆蛋白饮食(试验组)或酪蛋白安慰剂(安慰剂组)干预,为期3个月。建立多变量模型以评价治疗效果。结果饮食干预后,仅在试验组受试者尿液中植物雌激素含量增高。试验组血压较安慰剂组下降明显[收缩压(-7.5±1.2)mm Hg比(-3.6±1.1)mm Hg,P<0.01;舒张压(-4.3±0.8)mm Hg比(-1.9±0.7)mm Hg,P<0.05;平均压(-5.5±1.0)mm Hg比(-0.9±1.0)mm Hg,P<0.008]。试验组血脂水平较安慰剂组有显著改变(P<0.001),其中试验组低密度脂蛋白胆固醇/高密度脂蛋白胆固醇比值显著下降[(-0.33±0.10) mmol/L比(0.04±0.10) mmol/L,P<0.05],甘油三酯水平也有显著下降[(-0.20±0.05)mmol/L比(-0.01±0.05)mmol/L,P<0.05],而脂蛋白(a)水平升高(±95%可信区间)[42(17-67)mg/L比4(-22-31)mg/L,P<0.05]。两组中总胆固醇和低密度脂蛋白胆固醇水平均下降,高密度脂蛋白胆固醇水平升高。副作用的发生率两组相似,并且都没有观察到男性激素水平发生改变。结论在正常血压男性和绝经后女性人群中,大豆饮食对血压和血脂水平有改善作用。

Objective To determine the effects of dietary soy containing phytoestrogens on blood pressure and lipids in healthy volunteers. Methods Two hundred thirteen healthy volunteers （ 108 men and 105 post-menopausal women, 50-76 years old） received either soy protein isolate （40 g soy protein, 118 mg isoflavones） or cassin placebo for 3 months in this randomized, double-blind trial. Results There were 34 withdrawals （ 16% ） and 179 people （96 men and 83 women） completed the study protocol. After 3 months treatment, urinary phytoestrogens was significantly increased and blood pressure was significant reduced in soy protein group than that in cassin placebo group [ mean change in systolic （ - 7.5 ± 1.2） mm Hg vs. （-3.6±1.1） mmHg, P〈0.05; diastolic： （ -4.3 ±0.8 ）ram Hgvs （ -1.9±0.7 ）mm Hg, P〈0.05; mean aortic blood pressure ： （ - 5.5 ± 1.0） mm Hg vs （ - 0. 9 ± 1.0） mm Hg, P 〈 0. 008 ]. Low- to high- density lipoprotein ratio[ （ -0. 33 ± 0. 10）mmol/L vs （0. 04 ± 0. 10）mmol/L, P 〈 0. 05 ] and triglycerides [ （ - 0. 20 ± 0. 05 ） mmol/L vs （ - 0. 01 ± 0. 05 ） mmol/L, P 〈 0. 05 ] were significantly reduced and Lp （a） lipoprotein significantly increased [ 42 （ 17 - 67 ） mg/L vs 4 （ 22 - 31 ） mg/L, P 〈 0. 05 ] in soy protein group compared to cassin placebo group. Total, low-density lipoprotein, and high-density lipoprotein cholesterols all improved in both groups and were similar between the groups. No side-effect was observed in both groups and no effect on the hypothalamic-pituitary-gonadal axis was noted in study subjects. Conclusion In normotensive men and post-menopausal women, phytoestrogens intake improved blood pressure and lipids status.