Prevention of bone resorption by intake of phytoestrogens in postmenopausal women: a meta-analysis

Salari, Pooneh; Nikfar, Shekoufeh; Abdollahi, Mohammad

doi:10.1007/s11357-010-9180-6

Cited by 16 publications

(6 citation statements)

References 41 publications

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“…Other mechanisms include the influence on calcium absorption and its urinary excretion, prostaglandin synthesis, osteoblast formation and lipid oxidation. The beneficial effect of phytoestrogens on bone resorption markers, and BMD in postmenopausal women in some meta-analysis of randomized controlled trials was reported, in contrast to others [ 112 – 115 ]. The effect of isoflavones on fracture risk was not seen.…”

Section: Introductionmentioning

confidence: 83%

New horizons in treatment of osteoporosis

et al. 2017

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BackgroundPrevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects.Main bodyThis review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines. As well, the effect of combination therapy and recommendations for future research will be further discussed.Short conclusionThe use of current antiresorptive and anabolic agents alone or in combinations for the treatment of osteoporosis entails several limitations. Mainly, their efficacy on non-vertebral fracture reduction is lower than that observed on vertebral fracture. In addition, they have potential adverse events on long time usage. Development of newer agents such as cathepsin k inhibitor and strontium ranelate not only have increased the available options for treating osteoporosis, but also have opened doors of opportunity to improvements in the effective treatment. However, the high cost of new agents have restricted their usage in selective patients who are at high risk of fracture or whom failed response to first line treatment options. Thus, personalized medicine should be considered for future evaluation of genetic risk score and also for environmental exposure assessment. In addition to permanent attention to early diagnosis of osteoporosis and understanding of the pathophysiology of osteoporosis for novel approach in drug discovery, there seems a need to more well-designed clinical trials with larger sample sizes and longer duration on current as well as on newer agents. Also, continuous research on plant-derived components as the source of discovering new agents, and conducting more clinical trials with combination of two or more synthetic drugs, plants, or drug-plant for the treatment of osteoporosis are recommended.Graphical AbstractSummary of treatment modalities for osteoporosis.

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Section: Introductionmentioning

confidence: 83%

New horizons in treatment of osteoporosis

et al. 2017

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“…Phytoestrogens have several potential applications in different diseases. Phytoestrogens decrease bone resorption and delay the progression of osteoporosis in Post-MW [13], exert anti-androgenic effects which could be useful in benign prostatic hypertrophy [14], and may have protective effects in prostate and breast cancers [15], and neuroprotective effects that could improve cognitive functions of the brain [16]. Phytoestrogens also showed a potential to improve CV function and to decrease the risk of CVD associated with menopause [17].…”

Section: Introductionmentioning

confidence: 99%

Vascular Effects of Phytoestrogens and Alternative Menopausal Hormone Therapy in Cardiovascular Disease

Gencel¹,

Benjamin²,

Bahou³

et al. 2012

MRMC

117

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Phytoestrogens are estrogenic compounds of plant origin classified into different groups including isoflavones, lignans, coumestans and stilbenes. Isoflavones such as genistein and daidzein are the most studied and most potent phytoestrogens, and are found mainly in soy based foods. The effects of phytoestrogens are partly mediated via estrogen receptors (ERs): ERα, ERβ and possibly GPER. The interaction of phytoestrogens with ERs is thought to induce both genomic and non-genomic effects in many tissues including the vasculature. Some phytoestrogens such as genistein have additional non-ER-mediated effects involving signaling pathways such as tyrosine kinase. Experimental studies have shown beneficial effects of phytoestrogens on endothelial cells, vascular smooth muscle, and extracellular matrix. Phytoestrogens may also affect other pathophysiologic vascular processes such as lipid profile, angiogenesis, inflammation, tissue damage by reactive oxygen species, and these effects could delay the progression of atherosclerosis. As recent clinical trials showed no vascular benefits or even increased risk of cardiovascular disease (CVD) and CV events with conventional menopausal hormone therapy (MHT), phytoestrogens are being considered as alternatives to pharmacologic MHT. Epidemiological studies in the Far East population suggest that dietary intake of phytoestrogens may contribute to the decreased incidence of postmenopausal CVD and thromboembolic events. Also, the WHO-CARDIAC study supported that consumption of high soybean diet is associated with lower mortalities from coronary artery disease. However, as with estrogen, there has been some discrepancy between the experimental studies demonstrating the vascular benefits of phytoestrogens and the data from clinical trials. This is likely because the phytoestrogens clinical trials have been limited in many aspects including the number of participants enrolled, the clinical end points investigated, and the lack of long-term follow-up. Further investigation of the cellular mechanisms underlying the vascular effects of phytoestrogens and careful evaluation of the epidemiological evidence and clinical trials of their potential vascular benefits would put forward the use of phytoestrogens as an alternative MHT for the relief of menopausal symptoms and amelioration of postmenopausal CVD.

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“…The fasting morning blood samples were collected for quantification of serum β -CTx levels to avoid being confounded by circadian variation and food intake [ 52 ]. It is not surprising that serum β -CTx in this case considerably decreased from baseline after an eight-week isoflavone intervention as other studies have shown that isoflavones can significantly decrease various bone resorption markers (i.e., CTx, pyridinoline, and deoxypyridinoline) [ 47 – 49 , 53 ]. In fact, this desirable effect may be observed in as early as three weeks following the intervention [ 47 ].…”

Section: Discussionmentioning

confidence: 63%

“…It is not surprising that serum β -CTx in this case considerably decreased from baseline after an eight-week isoflavone intervention as other studies have shown that isoflavones can significantly decrease various bone resorption markers (i.e., CTx, pyridinoline, and deoxypyridinoline) [ 47 – 49 , 53 ]. In fact, this desirable effect may be observed in as early as three weeks following the intervention [ 47 ]. It is possible that a decline in serum β -CTx such as that found in this study might be able to predict subsequent improvement in the lumbar spine or femoral bone mineral density (if patient continues taking isoflavone capsules for one or two years) [ 51 ].…”

Section: Discussionmentioning

confidence: 63%

“…They also provide information about the effectiveness of osteoporosis treatment, in spite of not being useful alone to estimate bone loss [ 46 ]. It has been demonstrated that isoflavone intervention can prevent bone resorption, but its benefits for bone formation are not significant [ 29 , 30 , 47 – 50 ]. Bone resorption markers, especially serum C-terminal telopeptide of type I collagen (CTx) and its degradation fragments that contain the beta-isomerized octapeptide EKAHD-beta-GGR ( β -CTx), are therefore better indicators than bone formation markers for assessing the response to intervention in postmenopausal women [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

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Short-Term Isoflavone Intervention in the Treatment of Severe Vasomotor Symptoms after Surgical Menopause: A Case Report and Literature Review

Teekachunhatean

Mattawanon

Khunamornpong

2015

Case Reports in Obstetrics and Gynecology

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Isoflavones are soy phytoestrogens that potentially exert various favorable effects in postmenopausal women, for example, alleviating vasomotor episodes, attenuating bone loss, and stimulating vaginal epithelial maturation. There has, however, been lack of consensus regarding those therapeutic effects. Most clinical studies of isoflavones have been conducted with women who had undergone natural menopause, but not those who had undergone surgical menopause. This study reports on a 51-year-old woman who presented with severe vasomotor episodes after undergoing a hysterectomy and a bilateral oophorectomy due to hypermenorrhea secondary to myoma uteri. She refused hormone therapy due to fear of adverse drug reactions so was treated with oral soy isoflavones (two capsules twice daily, equivalent to at least 100 mg daily dose) for 8 weeks. The number and severity of hot flushes and her menopause-specific quality of life dramatically improved from baseline values. The serum bone resorption marker (beta C-telopeptide) decreased markedly, while vaginal epithelial maturation improved slightly, suggesting the potential of isoflavones in attenuating bone loss and stimulating vaginal maturation. The intervention did not adversely affect the hormonal profile (FSH, LH, and estradiol) and liver or renal functions. Thus, isoflavones could be an option for women experiencing severe vasomotor episodes after surgical menopause.

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Prevention of bone resorption by intake of phytoestrogens in postmenopausal women: a meta-analysis

Cited by 16 publications

References 41 publications

New horizons in treatment of osteoporosis

New horizons in treatment of osteoporosis

Vascular Effects of Phytoestrogens and Alternative Menopausal Hormone Therapy in Cardiovascular Disease

Short-Term Isoflavone Intervention in the Treatment of Severe Vasomotor Symptoms after Surgical Menopause: A Case Report and Literature Review

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