Abstract
The aim of the report was to investigate the impact of soy protein and isoflavones on glucose homeostasis and lipid profile in type 2 diabetes. The studies used in this report were identified by searching through the MEDLINE and EMBASE databases (up to 2020). Meta-regression and subgroup analyses were performed to explore the influence of covariates on net glycemic control and lipid changes. Weighted mean differences and 95% confidence intervals (CI) were calculated by using random-effect models. Changes in the lipid profile showed statistically significant decreases in total cholesterol and LDL-C concentrations: ‒0.21 mmol/L; 95% CI, ‒0.33 to ‒0.09; p = 0.0008 and ‒0.20 mmol/L; 95% CI, ‒0.28 to ‒0.12; p < 0.0001, respectively, as well as in HDL-C (−0.02 mmol/L; 95% CI, −0.05 to 0.01; p = 0.2008 and triacylglycerols (−0.19 mmol/L; 95% CI, −0.48 to 0.09; p = 0.1884). At the same time, a meta-analysis of the included studies revealed statistically insignificant reduction in fasting glucose, insulin, HbA1c, and HOMA-IR (changes in glucose metabolism) after consumption of soy isoflavones. The observed ability of both extracted isoflavone and soy protein with isoflavones to modulate the lipid profile suggests benefits in preventing cardiovascular events in diabetic subjects. Further multicenter studies based on larger and longer duration studies are necessary to determine their beneficial effect on glucose and lipid metabolism.
Highlights
Diabetes mellitus has been widely recognized to be a fundamental and leading cause of major health issues, such as cardiovascular disease
Of the total of 12 articles included in this meta-analysis: (a) nine reported on glucose metabolism [21,22,34,35,36,37,38,39,40], including eight that concerned fasting blood glucose (FBG) [21,22,34,35,36,37,39,40], seven dealt with fasting insulin (FI) [21,22,34,35,37,39,40], five were about HbA1c [21,22,38,39,40] and five were homeostasis model assessments of HOMA-IR [21,22,34,35,37,39]; and (b) nine reported lipid profiles [21,22,23,36,37,39,40,41,42]
Five studies were of parallel randomized design [21,22,23,34,36], and seven studies used cross-over randomized design [35,37,38,39,40,41,42]
Summary
Diabetes mellitus has been widely recognized to be a fundamental and leading cause of major health issues, such as cardiovascular disease. In the United States, in 2018, 34.2 million people were thought to be diabetic (10.5% of the U.S population), including 26.9 million people (26.8 million adults) confirmed and 7.3 million unconfirmed (21.4%) [2]. Obesity and diabetes are major causes of morbidity and mortality in the United States [2]. A variety of metabolic disorders, such as obesity, hypertension and dyslipidemia very often coexist with diabetes [5,6]. Lifestyle factors, those associated with obesity, and a rapid increase in the intake of fat, notably saturated fatty acids, as well as a decrease in physical activity contribute to developing T2DM [7,8]
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