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Role of Soy and Isoflavone Extract in the Management of

Postmenopausal Osteoporosis Patients from Narowal-Pakistan

A thesis submitted to

Minhaj University Lahore

(Pakistan) By

Safia Naseer

Registration No: 2017F-mulmpl-bioche-

07 Roll no: 07

Session fall 2017-2019

For

The degree of Master of Philosophy in Biochemistry

Supervised by:
Dr. Kashif-Ur-Rehman
School of Biochemistry
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SUPERVISORY COMMITTEE

We, the Supervisory Committee, certify that the contents and form of the thesis,
submitted by, Safia Naseer Regd. No. 2017F-mulmpl-bioche-07 have been found
satisfactory and recommend that it be processed for the evaluation by the External
Examiner(s) for the award of the degree.

SUPERVISOR: DR. KASHIF-UR-REHMAN

Assistant Professor

School of Biochemistry

Minhaj University Lahore

CHAIRMAN: DR. SUMAIRA MEHBOOB

HOD

School of Biochemistry

Minhaj University Lahore

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DECLARATION

Safia Naseer (Registration No: 2017F-mulmpl-bioche-07), student of M.Phil

biochemistry, session 2018-2020, hereby declare that the material printed in this thesis
entitled “ROLE OF SOY AND ISOFLAVONE EXTRACT IN THE
MANAGEMENT OF POSTMENOPAUSAL OSTEOPOROSIS PATIENTS FROM
NAROWAL-
PAKISTAN” is my work and not copied from any source and have not published, printed
and submitted as a research work, thesis or publication in any form in any university or
research journal or institution etc.

Safia Naseer
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PLAGIARISM REPORT

This is to certify that I have examined the Turnitin report of the thesis entitle“Role of Soy
and Isoflavone Extract In The Management Of Postmenopausal Osteoporosis Patients
From Narowal-Pakistan”. The thesis contains no text that can be regarded as plagiarism.
The overall similarity index obtained from the Turnitin software is %

Supervisor
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CERTIFICATE

It is hereby stated that this project entitled “Role of Soy and Isoflavone Extract In The

Management Of Postmenopausal Osteoporosis Patients From Narowal-Pakistan ”is

conducted by AMINA KHURSHEED ASHRAF under my supervision. No part of this

work has previously been presented for higher degree in this university or any other

institute of learning in best of the author’s knowledge.

He has fulfilled all the requirements and is qualified to------------------for the degree of M.

Phil Biochemistry.

Examination Committee

SUPERVISOR: External Examiner:

Dr. KASHIF-Ur-REHMAN

Assistant Professor

School of Biochemistry

Minhaj University Lahore

Dr. SUMAIRA MEHBOOB

HOD School of Biochemistry

Minhaj University Lahore

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“In the name of ALLAH, THE Most

Merciful and Compassionate, THE Most
Gracious and Beneficent
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Dedicated

To

My Parents

Teachers

&

Brothers / sister
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ACKNOWLEDGEMENTS

All praises and glories are to the Creator “ALLAH”, the Almighty, Most Beneficent, the

Most Merciful and the sustainer of the Worlds. Peace and Blessing be upon the Prophet

Mohammed, Peace be upon Him (PBUH). Praise be to Allah (The Almighty) for the

blessing given to me, so that, I can finally complete this work. I bow my compassionate

endowments and peace is upon Holy Prophet ‫ ﷺ‬who is ever an ember of guidance

and

knowledge for humanity.

I am very much gratified to Almighty ALLAH, for blessing me with the opportunity

to work in an emerging University; Minhaj University Lahore (MUL) under the kind

supervision of respectable Dr. Kashif–ur-Rehman who has greatly refined my

professional attitude and skills. I would like to express my sincere thanks to him for

providing me with all the necessary facilities, for his keen interest and encouragement for

the successful accomplishment of the present study.

Last but not the least; I can never forget the efforts of my beloved parents, teachers,

and family members. I am also greatly indebted to my beloved father, Naseer Ahmad

who encouraged me a lot to join this M. Phil degree and help me a lot regarding my

research work. It may not be enough to certain the words of thanks giving. It may not

capture the endearing love that I have for all of them, but now I am making the

compilations to let the world know that their place is a place of love, generosity and

benevolence. “May Allah give a long, prosperous and happy life to my family (Ameen).

Safia Naseer
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CONTENTS

DEDICATION A

ACKNOWLEDGEMENTS B

LIST OF TABLES D

LIST OF FIGURES E

LIST OF ANNEXURES E

LIST OF GRAPHS F

SR. PAGE
CHAPTERS
NO. NO.

1. INTRODUCTION 1

2. REVIEW OF LITERATURE 18

3. MATERIALS AND METHODS 31

4. RESULTS, DISCUSSION AND CONCLUSION 47

7. LITERATURE CITED 61
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LIST OF TABLES

TABLE NO. TITLE PAGE

NO.

4.1 Demographic characteristics of study participants 49

4.2 Soy isoflavone treated patients 49

4.3 The concentration of Calcium in serum of patients 51

treated with isoflavone and placebo

4.4 The concentration of Phosphorous in serum of 53

patients treated with isoflavone and placebo

4.5 The concentration of ALP in serum of patients 55

treated with isoflavone and placebo

LIST OF FIGURES

FIGURE NO. TITLE PAGE

NO.

3.1 Vacutainers for blood collection 35

3.2 Mix grinder for soybean 36

3.3 Stone grinder for soybean 37

3.4 Colloid mill for soybean 38

3.5 Machine for soy milk extraction 39

3.6 Automatic biochemistry analyzer 45

4.1 Radiograph of a woman having normal lumbosacral region. 48

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4.2 Lumbosacral radiograph of osteoporotic women. 48

4.3 Lumbosacral radiograph of a woman after treating 50

with soy isoflavone.

LIST OF GRAPHS

Graph TITLE PAGE

NO. NO.

4.1 Serum calcium concentrations of the 52

osteoporotic patients treated with soy isoflavone
and placebo
4.2 Serum Phosphorous concentrations of the 54
osteoporotic patients treated with soy isoflavone and
placebo
4.3 Serum ALP concentrations of the osteoporotic 56
patients treated with soy isoflavone and placebo
 Abstract
Osteoporosis is being characterized by low bone mass and structural decline of bone tissue has
a huge crash on public health through high morbidity and death. The avoidance and treatment
of brittleness fractures in the osteoporosis patients worldwide becomes burning issue in the
recent clinical practice. Women often have an accelerated bone loss after menopause
consequently in a lower bone mass as compared to men. This study was conducted to evaluate
the therapeutic effects of soy and isoflavone for postmenopausal osteoporosis in the women
from District Narowal, Punjab Pakistan. A total number of 80 women selected after the lumber
spine digital X ray. These women were divided in to the two groups. In the group I forty
women were kept and treated with Soy isoflavone. In the group II 40 women were kept and
treated with placebo. The second group was kept as control. The women of group I was given
130 ml soy isoflavone on the daily basis (65 ml in the morning and 65 ml in the evening). This
treatment was continued for 10 weeks. After 10 weeks the blood samples were collected and
processed for biochemical parameters to access the bone strength. Three biochemical
parameters were determined in the serum (Calcium, Phosphorus and ALP). Soy isoflavone
increased the serum calcium (1.3 mg/dl) and phosphorus (2.5 mg/dl) concentrations while
decreased the ALP (81 U/L) concentrations which indicate it has positive effect on the bone
strength. In group 1 for serum calcium before treatment comes out to be 8.2±0.14mg/dl and
after treatment 9.5±0.13mg/dl with a significant value (p<0.000) showing an increased
BMD which lessen osteoporosis condition. While group II serum calcium level was
8.4±0.17mg/dl before treatment and 8.7±0.2 mg/dl after treatment with p value of 0.06.
Calcium with significant value (p<0.03) indicate an increase intake of isoflavone directly
participate to increase bone strength as a result osteoporosis minimize. Phosphorus level was
2.1±0.3mg/dl before treatment while after treatment serum phosphorus concentration was
increased i.e. 4.6+0.12mg/dl with p<0.04 which showed statistically significant
difference. In group II concentration of serum phosphorus before treatment was
2.0±0.4mg/dl and after treatment was 2.3+0.16mg/dl with p value 0.07. The significant
value of serum phosphorus (p<0.04) showed an effect in bones of osteoporotic
postmenopausal women. Increase the deposition of Calcium as well as phosphorus
indicates positive effect on bones for its strength. The concentration of serum ALP before
treatment was 174±6u\L and after treatment was 93±4u/L with (p<0.02). In group II the
concentration
of serum ALP was 169±4 u/L before treatment while after treatment its concentration
was 160±5u/L with (p<0.06). Alkaline phosphate with a significant value (p<0.02)
showing decrease level by taking isoflavone. Soy isoflavone increased the serum calcium
and phosphorous concentrations while decreased the ALP concentrations which indicate it has
positive effect on the bone strength. While in the group II no significant difference was
observed in the concentration of these biochemical markers. From this study it is concluded
that Soy isoflavone has the ability to treat the postmenopausal osteoporosis but still further
studies are required to set the dose of soy isoflavone for this treatment at the commercial level.