title: The differential effect of the phytoestrogen genistein on cardiovascular risk factors in postmenopausal women: relationship with the metabolic status.
abstract: BACKGROUND
  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.
  
  
  METHODS
  A randomized placebo controlled study was conducted at a university hospital.
  
  
  METHODS
  Fifty postmenopausal women participated.
  
  
  METHODS
  Thirty subjects (group A) were randomized to receive 54 mg/d genistein while 20 subjects (group B) were treated with the placebo for 24 wk. In group A, we distinguish two subgroups: 14 normoinsulinemic and 12 hyperinsulinemic patients.
  
  
  METHODS
  Anthropometric measures, hormonal and lipid assays, oral glucose tolerance test with glycemic, insulin, and C-peptide evaluation, indexes of insulin sensitivity and endothelial function, and euglycemic-hyperinsulinemic clamps were performed.
  
  
  RESULTS
  The insulin basal values significantly decreased in group A, whereas the homeostasis model index of insulin sensitivity and the fasting glucose levels significantly improved compared with placebo group. The genistein administration decreased fasting glucose and area under the curve glucose levels in the normoinsulinemic patients after treatment. In the hyperinsulinemic patients, a significant reduction in fasting insulin, fasting C-peptide, and area under the curve insulin levels as well as an increase in fractional hepatic insulin extraction was shown. In these patients, high-density lipoprotein 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, whereas 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.
authors.affiliation: Department of Obstetrics and Gynaecology, Catholic University of Sacred Heart, Rome, Italy. paolavilla@rm.unicatt.it
authors.forename: Paola
authors.initials: P
authors.lastname: Villa
authors.forename: Barbara
authors.initials: B
authors.lastname: Costantini
authors.forename: Rosanna
authors.initials: R
authors.lastname: Suriano
authors.forename: Concetta
authors.initials: C
authors.lastname: Perri
authors.forename: Francesca
authors.initials: F
authors.lastname: Macrì
authors.forename: Luigi
authors.initials: L
authors.lastname: Ricciardi
authors.forename: Simona
authors.initials: S
authors.lastname: Panunzi
authors.forename: Antonio
authors.initials: A
authors.lastname: Lanzone
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001916:Brachial Artery / Q000187:drug effects / Q000502:physiology; D002318:Cardiovascular Diseases / Q000209:etiology*; D004730:Endothelium, Vascular / Q000187:drug effects / Q000502:physiology; D005260:Female; D019833:Genistein / Q000494:pharmacology*; D015309:Glucose Clamp Technique; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology; D008875:Middle Aged; D048789:Phytoestrogens / Q000494:pharmacology; D010919:Placebos; D017698:Postmenopause / Q000097:blood / Q000187:drug effects* / Q000378:metabolism*; D012039:Regional Blood Flow / Q000187:drug effects; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D048789:Phytoestrogens; D010919:Placebos; D019833:Genistein