Cardiovascular Diseases Clinical Trial
Official title:
Soy and Lipoproteins in Postmenopausal Women
To determine the effects of soy on lipids, lipoproteins and lipoprotein subclass in a sample of African-American and white postmenopausal women with low-density lipoprotein (LDL) cholesterol elevations that may increase their lifetime risk for cardiovascular disease but would not qualify for definite pharmacotherapy under current guidelines.
BACKGROUND:
Cardiovascular disease (CVD) remains the leading cause of mortality and disability in
postmenopausal women. Menopause alters serum lipids and lipoproteins to produce a more
atherogenic lipid profile that may contribute significantly to the increased risk for the
development of CVD over the lifetime of women. Clinical trials have demonstrated a beneficial
effect of soy protein containing isoflavones (soy) on plasma lipids and lipoproteins;
however, these studies included small numbers of postmenopausal women and virtually none
included sufficient African-American women. In addition, no published data existed in 2001 on
the impact of soy on atherogenic lipoprotein subclasses in postmenopausal women.
DESIGN NARRATIVE:
The study was a double blind, parallel group, randomized clinical trial. A total of 216
healthy postmenopausal women (50 percent African-American) with LDL cholesterol between 130
mg/dL and 190 mg/dL were enrolled. Following a pre-randomization run-in period on a NCEP Step
I diet, women were randomized to receive soy containing isoflavones or casein dietary
supplements for 3 months. Major outcome variables were assessed in both groups at baseline
and again at 3 months. It was hypothesized that soy supplementation would result in
significantly greater reduction in LDL cholesterol, LDL particle concentration, and
prevalence of dense LDL particles and improvement in menopausal quality of life compared with
placebo and that these effects would be comparable in African-Americans and whites. This was
the first study to determine whether a natural plant product could ameliorate the unfavorable
changes in known and novel lipid risk factors that are a consequence of menopause in both
African-American and white women. The unique transitional outcomes explored in this study
added substantially to the limited body of knowledge of the effects of soy. Evaluation of
this nutritional alternative to hormone replacement therapy (HRT) that may provide a
beneficial effect on lipid risk factors and menopausal symptoms but would be free of the
adverse effects on triglycerides, the breast and uterus, and thrombotic events associated
with HRT could have significant public health implications for postmenopausal women.
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