Isoflavone intervention and its impact on bone mineral density in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials

Ratchanon Inpan; Mingkwan Na Takuathung; Wannachai Sakuludomkan; Nahathai Dukaew; Supanimit Teekachunhatean; Nut Koonrungsesomboon

doi:10.1007/s00198-023-06944-y

Isoflavone intervention and its impact on bone mineral density in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials

Osteoporos Int. 2024 Mar;35(3):413-430. doi: 10.1007/s00198-023-06944-y. Epub 2023 Oct 25.

Authors

Ratchanon Inpan^{1

2

3}, Mingkwan Na Takuathung^{1

2}, Wannachai Sakuludomkan^{1

2}, Nahathai Dukaew^{1

2}, Supanimit Teekachunhatean^{1

2}, Nut Koonrungsesomboon^{4

5}

Affiliations

¹ Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
² Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
³ Office of Research Administration, Chiang Mai University, Chiang Mai, 50200, Thailand.
⁴ Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. nkoonrung@gmail.com.
⁵ Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand. nkoonrung@gmail.com.

PMID: 37875614
DOI: 10.1007/s00198-023-06944-y

Abstract

Due to estrogen deficiency, postmenopausal women may suffer from an imbalance in bone metabolism that leads to bone fractures. Isoflavones, a type of phytoestrogen, have been suggested to improve bone metabolism and increase bone mass. Therefore, isoflavones are increasingly recognized as a promising natural alternative to hormone replacement therapy for postmenopausal women who face a heightened risk of osteoporosis and are susceptible to bone fractures.

Purpose: This study aimed to evaluate the efficacy of isoflavone interventions on bone mineral density (BMD) in postmenopausal women by means of systematic review and meta-analysis.

Methods: The electronic database searches were performed on PubMed, Embase, Scopus, and Cochrane Library databases, covering literature up to April 20, 2023. A random-effects model was used to obtain the main effect estimates, with a mean difference (MD) and its 95% confidence interval (CI) as the effect size summary. The risk of bias assessment was conducted using the Risk of Bias 2 (RoB2) tool.

Results: A total of 63 randomized controlled trials comparing isoflavone interventions (n = 4,754) and placebo (n = 4,272) were included. The results indicated that isoflavone interventions significantly improved BMD at the lumbar spine (MD = 0.0175 g/cm²; 95% CI, 0.0088 to 0.0263, P < 0.0001), femoral neck (MD = 0.0172 g/cm²; 95% CI, 0.0046 to 0.0298, P = 0.0073), and distal radius (MD = 0.0138 g/cm²; 95% CI, 0.0077 to 0.0198, P < 0.0001) in postmenopausal women. Subgroup analysis showed that the isoflavone intervention was effective for improving BMD when the duration was ≥ 12 months and when the intervention contained genistein of at least 50 mg/day.

Conclusion: This systematic review and meta-analysis suggests that isoflavone interventions, especially those containing genistein of at least 50 mg/day, can effectively enhance BMD in postmenopausal women.

Keywords: Bone mineral density; Genistein; Isoflavones; Postmenopausal women.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Bone Density
Female
Fractures, Bone* / drug therapy
Genistein / pharmacology
Genistein / therapeutic use
Humans
Isoflavones* / pharmacology
Isoflavones* / therapeutic use
Osteoporosis, Postmenopausal* / drug therapy
Osteoporosis, Postmenopausal* / prevention & control
Postmenopause
Randomized Controlled Trials as Topic

Substances

Isoflavones
Genistein