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The effect of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled trials

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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 (< 6 weeks vs. ≥ 6 weeks) or gender (women only vs. men only vs. combined). Sensitivity analysis showed no difference in the effect of soy isoflavones between PWV, CAVI, SAC, and AI.

Conclusion

Supplementation of soy isoflavones reduced arterial stiffness. Longer duration trials with larger number of participants are warranted.

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Acknowledgements

The present systematic review and meta-analysis is funded in part by the National Institutes of Health (NIH) grants (NIEHS) R21 ES029734 and (NIA) RF1 AG051615.

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Authors and Affiliations

  1. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 130 North Bellefield Avenue, Pittsburgh, PA, 15213, USA

    Brian Man, Chendi Cui, Xiao Zhang, Daisuke Sugiyama, Emma Barinas-Mitchell & Akira Sekikawa

  2. Faculty of Nursing and Medical Care, Keio University, 4411 Endo, Fujisawa, Kanagawa, 252-0883, Japan

    Daisuke Sugiyama

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Contributions

CC, BM, AS, and XZ were essential to the entire research process including formulating the research question, designing and carrying out the study, and providing revisions at every stage. EB-M and DS provided crucial insight into the analysis of data and revision of intellectual content including careful examination of the article along with corresponding tables/figures. BM drafted the article and ran statistical analysis under the counsel of the other authors.

Corresponding author

Correspondence to Akira Sekikawa.

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The authors declare no conflicts of interest in relation to this research.

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394_2020_2300_MOESM1_ESM.pdf

Online Resource Figure 1a-f. Standardized mean difference (SMD) in arterial stiffness was presented for each study, displayed by four measurements of outcomes. Studies with multiple measurements of outcomes were removed individually to determine their effect on overall results. The summary SMD was calculated by a random effects model. (Sup 1) (PDF 213 kb)

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Man, B., Cui, C., Zhang, X. et al. The effect of soy isoflavones on arterial stiffness: a systematic review and meta-analysis of randomized controlled trials. Eur J Nutr 60, 603–614 (2021). https://doi.org/10.1007/s00394-020-02300-6

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  • DOI: https://doi.org/10.1007/s00394-020-02300-6

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