Association between Dietary Isoflavones in Soy and Legumes and Endometrial Cancer: A Systematic Review and Meta-Analysis

Abstract Background Epidemiologic studies have reported conflicting findings between soy- and legume-derived dietary isoflavones and risk of endometrial cancer. Objective The aim of the present meta-analysis was to quantitatively investigate the association between daily intake of soy- and legume-de...

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Published in:Journal of the Academy of Nutrition and Dietetics 2018-04, Vol.118 (4), p.637-651
Main Authors: Zhong, Xue-shan, MD, Ge, Jing, MD, Chen, Shao-wei, MD, Xiong, Yi-quan, PhD, Ma, Shu-juan, PhD, Chen, Qing, PhD
Format: Article
Language:English
Subjects:
Adult
Aged
Case-Control Studies
Diet - adverse effects
Diet - methods
Endometrial cancer
Endometrial Neoplasms - epidemiology
Endometrial Neoplasms - etiology
Endometrial Neoplasms - prevention & control
Fabaceae - chemistry
Female
Gastroenterology and Hepatology
Glycine max - chemistry
Humans
Incidence
Internal Medicine
Isoflavones
Isoflavones - administration & dosage
Legume
Meta-analysis
Middle Aged
Odds Ratio
Prospective Studies
Risk Factors
Soy
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Summary:Abstract Background Epidemiologic studies have reported conflicting findings between soy- and legume-derived dietary isoflavones and risk of endometrial cancer. Objective The aim of the present meta-analysis was to quantitatively investigate the association between daily intake of soy- and legume-derived isoflavones and risk of endometrial cancer. Design A broad search was conducted in the following electronic databases: PubMed, EMBASE, Google Scholar, the Cochrane Library, the China Knowledge Resource Integrated Database, and the Chinese Biomedical Database based on combinations of the key words endometrial cancer , isoflavone , soy , and legume for epidemiologic studies that focused on relationships between dietary isoflavones and endometrial cancer risk. A fixed-effect or random-effect model was used to pool study-specific risk estimates. Results A total of 13 epidemiologic studies were included in the present meta-analysis, consisting of three prospective cohort studies and 10 population-based case-control studies. The final results indicated that higher dietary isoflavone levels from soy products and legumes were associated with a reduced risk of endometrial cancer (odds ratio [OR] 0.81, 95% CI 0.74 to 0.89). Low heterogeneous bias was observed ( I2 =11.7%; P =0.327). Subgroup analyses were conducted based on study design, source of dietary isoflavones, and study region. When restricted to study design, dietary isoflavones from soy and legumes played a role in prevention of endometrial cancer in case-control studies (OR 0.81, 95% CI 0.73 to 0.90). However, there did not appear to be an association between dietary isoflavones and endometrial cancer in cohort studies (OR 0.81, 95% CI 0.66 to 1.00). Significant associations were found between dietary isoflavones from soy products (OR 0.82, 95% CI 0.72 to 0.92) and legumes (OR 0.84, 95% CI 0.74 to 0.96) and endometrial cancer. Dietary isoflavones were associated with reduced incidence of endometrial cancer, both in Asian countries (OR 0.78, 95% CI 0.66 to 0.93) and non-Asian countries (OR 0.82, 95% CI 0.73 to 0.92). Conclusions The findings suggest a weak inverse association between higher consumption of dietary isoflavones from soy products and legumes and endometrial cancer risk. However, there is still a need for large, prospective epidemiologic studies that provide a higher level of evidence to verify these findings.
ISSN:2212-2672
2212-2680
DOI:10.1016/j.jand.2016.09.036