The effect of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled tria
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REVIEW
The effect of soy isoflavones on arterial stiffness: a systematic review and meta‑analysis of randomized controlled trials Brian Man1 · Chendi Cui1 · Xiao Zhang1 · Daisuke Sugiyama1,2 · Emma Barinas‑Mitchell1 · Akira Sekikawa1 Received: 28 December 2019 / Accepted: 5 June 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Some but not all randomized controlled trials (RCTs) of soy isoflavones showed their beneficial effect on arterial stiffness, a predictor of cardiovascular events, dementia, and all-cause mortality, independent of traditional risk factors. To test the hypothesis that supplementation of soy isoflavones reduces arterial stiffness, we performed a systematic review and meta-analysis of RCTs of soy isoflavones on arterial stiffness. Methods The protocol of this systematic review was registered with PROSPERO (CRD42019126128) and written in accordance with PRISMA. The PubMed, Embase, and clinicaltrials.gov databases were searched using the following criteria: human subjects, soy isoflavones as intervention, and arterial stiffness as primary outcome. A random-effects meta-analysis was used to pool estimates across studies. Standardized mean difference (SMD) was used to synthesize quantitative results. Results Among 998 articles retrieved, 8 articles met our criteria. Duration of intervention was relatively short (maximum of 12 weeks). Outcome measurements extracted were pulse wave velocity (PWV), systemic arterial compliance (SAC), augmentation index (AI), and cardio-ankle vascular index (CAVI). Soy isoflavones reduced arterial stiffness compared to placebo (standardized mean difference − 0.33, 95% confidence interval − 0.47, − 0.19). Subgroup analyses showed no difference between treatment effects for intervention duration ( 85 mmHg
DB double-blind, PC placebo-controlled, P parallel design, CO crossover design
b
a
n = 20 (11/9) PC, CO Pennsylvania, USA Richter, 2017 [16]
Pre- and postmenopausal women and men with moderately elevated resting blood pressure
6
Blood pressure level Intervention duration (weeks) Study designa Sample size (women/men) Study location Study (first author, year published)
Table 1 (continued)
Study population
Age (year)
Intervention dose
Washout period (weeks)
European Journal of Nutrition
were crossover design and had washout periods lasting 0–4 weeks [13–16, 18–20] while one study was parallel design [17]. Two studies included only women [14, 19], one study included only men [13], and five studies included both women and men [15–18, 20]. Across all studies, there were 276 women and 209 men with participants primarily in their 40 s and 50 s. Though our publication search parameters were large (1966–2019), included studies were all published between 1997 and 2017. Two studies were based in the United States, three in Australia, while one study in each of Finland, Japan, and the United Kingdom. Intervention duration ranged from 24 h to 12 weeks. Intervention dose ranged from 10 to 85 mg. Soy isoflavones were administered
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