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Evidence summaries

Isoflavones for Hypercholesterolaemia in Adults

There is insufficient evidence on the effect of isoflavones on lowering of cholesterol levels in people with hypercholesterolaemia. Level of evidence: "D"

The quality of evidence is downgraded by study limitations (unclear allocation concealment and blinding), by indirectness (all participants were postmenopausal women and most of the participants were recruited from non-Asian populations), and by imprecise results (few patients).

Summary

A Cochrane review [Abstract] 1 included 5 studies with a total of 208 subjects. The participants in the included trials were postmenopausal women, and the interventions ranged from 3 to 6 months. Three studies used isoflavones interventions and placebo controls, and 2 studies used soy protein-containing isoflavones and compared this with soy isolated protein plus less than 4 mg isoflavones/day. Isoflavones are plant-based chemicals related to phyto-oestrogen, which are found in soy and red clover. Asian people consume more isoflavones from their regular diet than Western people. Four studies reported results in non-Asian populations published in English and one study reported results in Chinese people published in Chinese. The Chinese study was excluded from meta-analysis due to substantial differences in clinical characteristics of participants. There were no outcome data on death from any cause, morbidity, complications, health-related quality of life and costs.

Compared with placebo, there was a statistically significant effect of isoflavones alone on triglycerides (MD -0.46 mmol/L, 95% CI -0.84 to -0.09; 2 studies, n=52) and no statistically significant effect on total cholesterol, LDL-cholesterol or HDL-cholesterol. There was no statistically significant effect of soy protein containing isoflavones on hypercholesterolaemia. Combined results for isoflavones versus placebo or soy protein + isoflavones versus soy protein are shown in table T1.

Isoflavones versus placebo or soy protein + isoflavones versus soy protein.

OutcomeParticipants (studies)Mean difference (95% CI)
Total cholesterol166 (4)-0.08 (-0.34 to 0.19)
LDL-cholesterol132 (3)-0.16 (-0.39 to 0.07)
HDL-cholesterol132 (3)-0.03 (-0.22 to 0.16)
Triglycerides165 (4)-0.15 (-0.43 to 0.13)

Two studies reported adverse effects, including gastrointestinal discomfort (bloating and constipation) and an increased number of hot flushes. None of the trials found serious adverse events.

Clinical comments

Note

Date of latest search:

References

  • Qin Y, Niu K, Zeng Y et al. Isoflavones for hypercholesterolaemia in adults. Cochrane Database Syst Rev 2013;(6):CD009518. [PubMed]

Primary/Secondary Keywords