Isoflavones對賀爾蒙補充治療之停經婦女血脂與脂蛋白及尿液雌激素代謝物的影響

The effect of supplementation with isoflavones on plasma lipids, lipoproteins and urinary estrogen metabolites in postmenopausalwomen with hormone replacement therapy

黃秋薇(Chiu-Wei Huang)

指導教授 ： 吳文惠

國立臺灣師範大學/教育學院/家政教育學系/碩士(1999年)

摘要

本研究目的主要探討isoflavones的攝取對於有接受賀爾蒙補充治療之停經後婦女血脂、尿液中雌激素代謝物2-hydroxyestrone (2OHE1)、16α-hydroxyestrone(16αOHE1)濃度及其比值2OHE1 /16αOHE1(乳癌生化指標)與抗氧化性的影響,以期了解isoflavones在保護心血管疾病與抗癌上的效果。
自醫院募集停經一年以上、身體健康且無服用isoflavones相關產品之停經婦女35名，受試者需接受賀爾蒙治療至少3個月以上，且方式為每天服用premarin 0.625毫克及provera 5毫克。實驗設計為單盲比較試驗，實驗前先給予每天6克的麥芽糊精作為安慰劑共14天，之後改服用純化自黃豆胚軸的isoflavones製劑，每天6克（約可攝取到114毫克isoflavones）共28天。實驗前後各採集一次空腹血液及早晨起床後第一次尿液，分析血漿及各種脂蛋白中的三酸甘油酯、膽固醇含量、血漿中總抗氧化狀態、isoflavones濃度、LDL氧化遲滯期和TBARS產生量與尿液中isoprostane、2OHE1、16αOHE1等含量的測量。
結果顯示服用isoflavones後血漿中daidzein濃度較基礎期明顯增加，然而血漿與各種脂蛋白中的膽固醇、三酸甘油酯並沒有顯著影響，但HDL-C濃度及LDL-C/ HDL-C比值則分別在服用isoflavones後顯著增加及減少。儘管血漿總抗氧化狀態與尿液中isoprostane濃度並無顯著差異但LDL體外氧化實驗則能夠延長氧化遲滯期並減少TBARS產生量。而尿液中雌激素代謝物分佈於服用isoflavones前後並無顯著差異。由本研究結果來看，isoflavones可上升HDL-C，進而下降LDL-C/ HDL-C比值，且能增加LDL體外氧化耐受性及下降TBARS產生量，對停經後婦女在心血管疾病的預防上或許是有助益的，但對尿液雌激素代謝物則無影響。

關鍵字

isoflavones、賀爾蒙補充治療、三酸甘油酯、膽固醇、LDL氧化性、2OHE1、16αOHE1

並列摘要

Isoflavones are soy phytoestrogens that have been suggested to be cardioprotective and anticarcinogenic. The aims of this trial were to determine the effect of supplementation with isoflavones on plasma lipids, oxidisability of low density lipoprotein ex vivo and two major urinary estrogen metabolites ( as a biomarker for breast cancer risk ) in postmenopausal women with hormone replacement therapy. Thirty-five apparently healthy postmenopausal women having taken combined continuous hormone replacement therapy (premarin 0.625mg, provera 5mg) for at least 3 monthes participated in a single-blind trial. An initial 14-day placebo period of supplementation with maltodextrin was followed by 28 -day periods of supplementation with 114mg isoflavones per day . Venous blood and fist morning urine sample were collected initially and at the end of isoflavone supple-mentation. Supplementation resulted in a 5-fold increase in plasma daidzein concentration. No changes in the plasma concentrations of total cholesterol , triglyceride or total antioxidant status and the urinary excretion of isoprostane or the estrogen metabolites : 2-hydroxyestrone, 16α-hydroxyestrone were observed following supplementation. However an significant beneficial effect was noted for the concentration of HDL-C or LDL-C /HDL-C ratio and in the oxidisability of LDL.The results suggest that isoflavones ameliorate the cardiovascular risk in postmenopausal women, but no effect on urinary estrogen metabolism.

並列關鍵字

isoflavone, HRT(Hormone replacement therapy), 2OHE1,16αOHE1, LDL oxidation .

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