Sandhyarani Guggilla*, Kiran Gangarapu, Ammavenu and Sarangapanim


Estrogen deficiency is a major cause of osteoporosis worldwide. Hormone Replacement Therapy (HRT) increases the bone mineral density (BMD) and decreases the fracture risk, but the adverse effects limit its use in a large cohort of subjects.[1,2,3] In the last few years, many researchers have focused their attention on natural alternatives to HRT, such as phytoestrogen. Epidemiological data indicate that women consuming high amounts of phytoestrogens, in the form of soy-derived dietary products, have less menopausal symptoms than those on Western diets, and consequently, it was assumed that bone mineral density may be favorably influenced by phytoestrogens.[4,5] A major phytoestrogen is genistein, which prevents bone mass loss and improves quality of life without the harmful estrogenic activity on reproductive tissues, or genotoxic effects in postmenopausal women, at least at the dose of 54 mg/day.[6,7,8,9,10,11,12] We have studied the effects of pure genistein (in its aglycone form) on BMD and bone metabolism in a large cohort of postmenopausal women[6], showing that a long-term intake of genistein produced a positive effect on bone metabolism with no clinically significant adverse effects on the breast and uterus.[7,8,9] Overall, these results agree with previous intervention trials in which >40 mg/day of genistein equivalents yielded the most positive effects on bone mineral density and bone markers when compared to other trials with lower amounts of genistein.[13,14,15,16] Animal studies suggest that genistein has an antiosteoporotic activity, improving bone morphology parameters in osteoporotic ovarictomized mice[17] and preventing bone fragility in rats with glucocorticoid-induced osteoporosis.[18] To date, no data are available on osteoporotic subjects, however a re-analysis of the 389 postmenopausal women enrolled in our previous trial, evaluating the efficacy of genistein in osteopenic women, revealed that a significant number was actually osteoporotic, according to the T-score. The aim of this study was to perform a post-hoc analysis to evaluate the efficacy of genistein aglycone on bone mineral density in women with osteoporosis.

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