title: Oral isoflavone supplementation on endometrial thickness: a meta-analysis of randomized placebo-controlled trials.
abstract: BACKGROUND
  Isoflavone from soy and other plants modulate hormonal effects in women, and the hormone disorder might result in different caners including endometrial cancer. However, it's effect on the risk of endometrial cancer is still inconclusive. We aimed to assess the effects of isoflavone on endometrial thickness, a risk factor of endometrial cancer in peri- and post-menopausal women.
  
  
  METHODS
  A meta-analysis of randomized controlled trials was conducted to evaluate the effect of oral isoflavone supplementation on endometrial thickness in peri- and post-menopausal women. Electronic searches were performed on the PubMed, Embase, the Cochrane Library, web of science, CINAHL, and WHO ICTRP to August 1st, 2015. Reviews and reference lists of relevant articles were also searched to identify more studies. Summary estimates of standard mean differences (SMD's) and 95%CIs were obtained with random-effects models. Heterogeneity was evaluated with meta-regression and stratified analyses.
  
  
  RESULTS
  A total of 23 trials were included in the current analysis. The overall results did not show significant change of endometrial thickness after oral isoflavone supplementation (23 studies, 2167subjects; SMD:-0.05; 95%CI:-0.23, 0.13; P=0.60). Stratified analysis suggested that a daily dose of more than 54mg could decrease the endometrial thickness for 0.26mm (10 trials, 984subjects; SMD:-0.26; 95%CI:-0.45, -0.07; P=0.007). Furthermore, isoflavone supplementation significantly decrease the endometrial thickness for 0.23mm in North American studies (7 trials, 726 subjects; SMD:-0.23; 95%CI:-0.44, -0.01; P=0.04), but it suggested an increase for 0.23mm in Asian studies (3 trials, 224 subjects; SMD: 0.23; 95%CI:-0.04, 0.50; P=0.10).
  
  
  CONCLUSIONS
  Oral isoflavone supplementation might have different effects in different populations and at different daily doses. Multiple-centre, larger, and long-term trials are deserved to further evaluate its effect.
authors.affiliation: Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Liu
authors.affiliation: Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
authors.forename: Feixiang
authors.initials: F
authors.lastname: Yuan
authors.affiliation: Nutrition Department, Affiliated Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Gao
authors.affiliation: Department of Female Tumor, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Boer
authors.initials: B
authors.lastname: Shan
authors.affiliation: Department of Female Tumor, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Yulan
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Female Tumor, Fudan University Shanghai Cancer Center, Shanghai, China.
authors.forename: Huaying
authors.initials: H
authors.lastname: Wang
authors.affiliation: Key Laboratory of Nutrition and Metabolism, Institute for Nutritional Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Gao
mesh_terms: D000284:Administration, Oral; D019587:Dietary Supplements; D004717:Endometrium / Q000187:drug effects* / Q000473:pathology*; D005260:Female; D006801:Humans; D007529:Isoflavones / Q000008:administration & dosage* / Q000009:adverse effects; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D007529:Isoflavones
keywords: Gerotarget; endometrial thickness; isoflavone supplementation; meta-analysis; randomized controlled trials