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November 17, 2004

Isoflavones and Postmenopausal Women

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(19):2338-2339. doi:10.1001/jama.292.19.2336-b

To the Editor: I would like to raise some methodological concerns about the study by Dr Kreijkamp-Kaspers et al.1 First, their assumption that soy isoflavones are equipotent to conventional hormone therapy is in error. Their power analysis indicates that they should have been able to detect a 6.7% increase in bone mineral density (BMD) based on 200 participants. They should have used 2-directional hypothesis testing and calculated power based on their actual sample size and, given that this magnitude of increase is within the range previously reported for bisphosphonates,2 a 3% change in response to isoflavones over 1 year may have been more realistic. Second, the authors state that “adjustment for smoking history and baseline BMD did not change the results,” but current smoking status and antihypertensive medication use should have been taken into account statistically.

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