The effects of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled trialsMan, Brian (2019) The effects of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled trials. Master Essay, University of Pittsburgh.
AbstractBackground: Recent studies indicate a possible association between soy isoflavones, a class of phytoestrogens, and arterial stiffness, a significant predictor of future cardiovascular events. We hypothesize that the supplementation of soy isoflavones compared to a placebo, would significantly reduce arterial stiffness. Objective: To evaluate the effect of soy isoflavones on arterial stiffness through the qualitative and quantitative analysis of relevant randomized controlled trials (RCTs). Methods: Selected studies were included in the systematic review process if they met the following criteria: participants were human subjects, primary treatment intervention was soy isoflavones, primary outcome was arterial stiffness, and the study was an RCT. Qualitative information extracted included study location, study design, sample size, population characteristics, intervention duration and dose, washout period, and the mean and standard deviation/error of baseline and after placebo or intervention. Studies of arterial stiffness based on pulse wave velocity (PWV), systemic arterial compliance (SAC), augmentation index (AI), and cardio-ankle vascular index (CAVI) were included in this review. Standardized mean difference (SMD) was used to synthesize the quantitative results. A subgroup analysis was conducted by intervention duration (<6 weeks vs. ≥6 weeks) and gender (women only vs. men only vs. combined). Results: A significant association that favored the positive effect of soy isoflavones on arterial stiffness was observed (Overall SMD: -0.37, 95% CI: -0.53, -0.21, p-value<0.01). A statistically significant effect was seen for PWV (SMD: -0.38, 95% CI: -0.71, -0.05), SAC (SMD: -0.39, 95% CI: -0.68, -0.11), and CAVI (SMD: -0.43, 95% CI: -0.83, -0.02), but not AI (SMD: -0.36, 95% CI: -0.85, 0.13). The subgroup analysis showed no significant difference between treatment effects of soy isoflavones on arterial stiffness for intervention duration and gender. Conclusion: Intake of soy isoflavones significantly reduced arterial stiffness. Therefore, soy isoflavones should be considered as a future intervention for arterial stiffness reduction. Public Health Significance: Arterial stiffness has major health implications for its connection to various adverse cardiovascular outcomes such as hypertension, chronic kidney disease (CKD), coronary heart disease (CHD), stroke, dementia, and all-cause mortality. Share
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