Phytoestrogenes in menopause: working mechanisms and clinical results in 28 patients
Authors:
V. Bičíková 1; L. Sosvorová 2; O. Bradáč 3; M. Pán 1; M. Bičíková 2
Authors‘ workplace:
Gynekologicko-porodnické oddělení, Oblastní nemocnice, Mladá Boleslav, primář MUDr. M. Pán
1; Endokrinologický ústav, Praha
2; Neurochirurgická klinika 1. LF UK, ÚVN a IPVZ, Praha
3
Published in:
Ceska Gynekol 2012; 77(1): 10-14
Category:
Original Article
Overview
Objective:
Comparison of phytoestrogen treatment efficacy in menopausal women with and without ability to metabolise phytoestrogens.
Design:
Clinical trial.
Setting:
Department of Obstetrics and Gynaecology, Regional Hospital, Mlada Boleslav.
Methods:
28 menopausal women were treated with phytoestrogens in dose 80 mg daily. Before start and after finishing of treatment urinary concentrations of active metabolite S-equol were measured using ELISA method. Similarly before and after treatment Kupperman’s index was measured. Patients with urinary concentrations of S-equol above 1 ng/ml were considered as S-equol producers, remaining patients formed control group.
Results:
16 out of 28 women were considered as S-equol producers, remainig 12 as a non-producers. Initial urinary concentrations of S-equol were 0.34 ± 0.37 ng/ml in producers group and 0.29 ± 0.30 ng/ml in non-producers. After finishing of therapy urinary concentration of S-equol increased to 10.67 ± 11.57 ng/ml (p = 0.002) in producers group and 0.34 ± 0.30 ng /ml (p = 0.701) in non-producers. Kupperman’s index values were 23.44 ± 11.57 in producers group and 17.25 ± 7.78 in non-producers. After therapy value of Kupperman’s index decreased to 14.44 ± 9.97 (p = 0.003) in producers and to 12.00 ± 7.18 (p = 0.100) in non-producers. No correlation between improvement in Kupperman’s index and urinary concentration of S-equol after therapy was found similarly as between urinary concentration of S-equol before and after therapy in producents group.
Conclusion:
Significant phytoestrogen treatment effect in menopausal women producing S-equol was proven. Testing method for S-equol production introduced by our team togehter with suggested threshold urine concentration level of 1 ng/ml allows precise distinction of producers and non-producers of S-equol and subsequently to predict better treatment effect of phytoestrogens.
Key words:
phytoestrogens, equol, menopause, clinical trial.
Sources
1. Axelson, M., Kirk, DN., Farrant, RD., et al. The identification of the weak oestrogen equol [7-hydroxy-3-(4’-hydroxyphenyl)chroman] in human urine. Biochem J, 1982, 201, p. 353-357.
2. Chen, YM., Ho, SC., Lam, SS., et al. Soy isoflavones have a favorable effect on bone loss in Chinese postmenopausal women with lower bone mass: a double-blind, randomized, controlled trial. J Clin Endocrinol Metab, 2003, 88, p. 4740-4747.
3. Clarkson, TB. Soy, soy phytoestrogens and cardiovascular disease. J Nutr, 2002, 132, p. 566S-569S.
4. Cornwell, T., Cohick W., Raskin, I. Dietary phytoestrogens and health. Phytochemistry, 2004, 65, p. 995-1016.
5. Erkkola, R., Vervarcke, S., Vansteelandt, S., et al. A randomized, double-blind, placebo-controlled, cross-over pilot study on the use of a standardized hop extract to alleviate menopausal discomforts. Phytomedicine, 2010, 17, p. 389-396.
6. Ferrari, A. Soy extract phytoestrogens with high dose of isoflavones for menopausal symptoms. J Obstet Gynaecol Res, 2009, 35, p. 1083-1090.
7. Heyerick, A., Vervarcke, S., Depypere, H., et al. A first prospective, randomized, double-blind, placebo-controlled study on the use of a standardized hop extract to alleviate menopausal discomforts. Maturitas, 2006, 54, p. 164-175.
8. Joannou, GE., Kelly, GE., Reeder, AY., et al. A urinary profile study of dietary phytoestrogens. The identification and mode of metabolism of new isoflavonoids. J Steroid Biochem Mol Biol, 1995, 54, p. 167-184.
9. Kupperman, HS., Blatt, MH., Wiesbader, H., et al. Comparative clinical evaluation of estrogenic preparations by the menopausal and amenorrheal indices. J Clin Endocrinol Metab, 1953, 13, p. 688-703.
10. Lampe, JW., Karr, SC., Hutchins, AM., et al. Urinary equol excretion with a soy challenge: influence of habitual diet. Proc Soc Exp Biol Med, 1998, 217, p. 335-339.
11. Levis, S., Strickman-Stein, N., Ganjei-Azar, P., et al. Soy isoflavones in the prevention of menopausal bone loss and menopausal symptoms: a randomized, double-blind trial. Arch Intern Med, 2011, 171, p. 1363-1369.
12. Marrian, GF., Haslewood, GAD. Observations of the constitution of the oestrus-producting hormone. Lancet, 1932, 260, p. 282-284.
13. Maruo, T., Sakamoto, M., Ito, C., et al. Adlercreutzia equolifaciens gen. nov., sp. nov., an equol-producing bacterium isolated from human faeces, and emended description of the genus Eggerthella. Int J Syst Evol Microbiol, 2008, 58, p. 1221‑1227.
14. Murkies, AL., Lombard, C., Strauss, BJ., et al. Dietary flour supplementation decreases post-menopausal hot flushes: effect of soy and wheat. Maturitas, 1995, 21, p. 189-195.
15. Muthyala, RS., Ju, YH., Sheng, S., et al. Equol, a natural estrogenic metabolite from soy isoflavones: convenient preparation and resolution of R- and S-equols and their differing binding and biological activity through estrogen receptors alpha and beta. Bioorg Med Chem, 2004, 12, p. 1559-1567.
16. Nagel, SC., vom Saal FS., Welshons, WV. The effective free fraction of estradiol and xenoestrogens in human serum measured by whole cell uptake assays: physiology of delivery modifies estrogenic activity. Proc Soc Exp Biol Med, 1998, 217, p. 300‑309.
17. Rowland, IR., Wiseman, H., Sanders, TA., et al. Interindividual variation in metabolism of soy isoflavones and lignans: influence of habitual diet on equol production by the gut microflora. Nutr Cancer, 2000, 36, p. 27-32.
18. Sathyamoorthy, N., Wang TT. Differential effects of dietary phyto-oestrogens daidzein and equol on human breast cancer MCF-7 cells. Eur J Cancer, 1997, 33, p. 2384-2389.
19. Setchell, KD., Borriello, SP., Hulme, P., et al. Nonsteroidal estrogens of dietary origin: possible roles in hormone-dependent disease. Am J Clin Nutr, 1984, 40, p. 569-578.
20. Setchell, KD., Brown, NM., Desai, PB., et al. Bioavailability, disposition, and dose-response effects of soy isoflavones when consumed by healthy women at physiologically typical dietary intakes. J Nutr, 2003, 133, p. 1027-1035.
21. Setchell, KD., Brown NM., Lydeking-Olsen, E. The clinical importance of the metabolite equol-a clue to the effectiveness of soy and its isoflavones. J Nutr, 2002, 132, p. 3577-3584.
22. Setchell, KD., Clerici, C., Lephart, ED., et al. S-equol, a potent ligand for estrogen receptor beta, is the exclusive enantiomeric form of the soy isoflavone metabolite produced by human intestinal bacterial flora. Am J Clin Nutr, 2005, 81, p. 1072-1079.
23. Somekawa, Y., Chiguchi, M., Ishibashi, T., et al. Soy intake related to menopausal symptoms, serum lipids, and bone mineral density in postmenopausal Japanese women. Obstet Gynecol, 2001, 97, p. 109-115.
24. Sosvorová, L., Lanková, P., Bičíková, M., et al. Elisa for free S-equol in human urine. Czech J Food Sci, 2011, 29, p. 57-64.
25. Tai, TY., Tsai, KS., Tu, ST., et al. The effect of soy isoflavone on bone mineral density in postmenopausal Taiwanese women with bone loss: a 2-year randomized double-blind placebo-controlled study. Osteoporos Int, 2011.
26. Taku, K., Melby, MK., Kurzer, MS., et al. Effects of soy isoflavone supplements on bone turnover markers in menopausal women: systematic review and meta-analysis of randomized controlled trials. Bone, 2010, 47, p. 413-423.
27. Thawornkuno, C., Tanaka, M., Sone, T., et al. Biotransformation of daidzein to equol by crude enzyme from Asaccharobacter celatus AHU1763 required an anaerobic environment. Biosci Biotechnol Biochem, 2009, 73, p. 1435‑1438.
28. Yokoyama, S., Suzuki, T. Isolation and characterization of a novel equol-producing bacterium from human feces. Biosci Biotechnol Biochem, 2008, 72, p. 2660-2666.
Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicineArticle was published in
Czech Gynaecology
2012 Issue 1
Most read in this issue
- Is the hysteroscopy the right choice for therapy of placental remnants?
- To conclude knowledge about new colposcopic signs – ridge sign and inner border.
- Risk factors for recurrent disease in borderline ovarian tumors
- The psychosocial needs of newborn children in the context of perinatal care