Villa P, Costantini B, Suriano R, Perri C, Macrì F, Ricciardi L, Panunzi S, Lanzone A
THE DIFFERENTIAL EFFECT OF THE PHYTOESTROGEN GENISTEIN ON CARDIOVASCULAR RISK FACTORS IN POSTMENOPAUSAL WOMEN: RELATIONSHIP WITH THE METABOLIC STATUS. [JOURNAL ARTICLE]
J Clin Endocrinol Metab 2008 Nov 18.
Context: The wide family of the phytoestrogens has become an alternative to the classical hormonal therapy in menopause, nevertheless some findings are still conflicting.
Objective: To examine the effect of genistein administration on metabolic parameters and vascular reactivity considering the basal endocrine status of the patients.
Design: Randomized placebo controlled study.
Setting: University Hospital.
Participants: 50 postmenopausal women. Intervention(s): Thirty subjects (group A) were randomized to receive 54 mg/day of genistein while twenty subjects (group B) were treated with the placebo for 24 weeks. In the group A we distinguish two subgroups: 14 normoinsulinemic and 12 hyperinsulinemic patients. Main Outcome Measure(s): Antropometric measures, hormonal and lipid assays, OGTT with glycemic, insulin and C-peptide evaluation, indexes of insulin sensitivity and endothelial function, euglycemic hyperinsulinemic clamps were performed.
Results: The insulin basal values significantly decreased in group A, where as the homeostasis model index of insulin sensitivity (HOMA-IR) and the fasting glucose levels significantly improved compared to placebo group. The genistein administration decreased fasting glucose and AUC-glucose levels in the normoinsulinemic patients after treatment. In the hyperinsulinemic patients a significant reduction in fasting insulin, fasting C-peptide and AUC-insulin levels as well as an increase in FHIE was shown. In these patients HDL cholesterol levels were significantly improved. The endothelium-dependent and independent dilatation improved in the treated group. Normoinsulinemic patients showed both a significantly enhanced flow mediated and nitrate mediated dilatation, while no significant changes were found in the hyperinsulinemic group.
Conclusions: The glycoinsulinemic metabolism and the endothelial function were significantly influenced by genistein. In particular normoinsulinemic patients showed an improvement in glycemic and vascular reactivity indexes. Conversely, an improvement in the insulin sensitivity indexes was noted in hyperinsulinemic patients.
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