Hormone replacement therapy is associated with increased C-reactive protein in women with Type 2 diabetes in the Diabetes Heart Study
Hormone replacement therapy is associated with increased C-reactive protein in women with Type 2 diabetes in the Diabetes Heart Study
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DOI：
10.1111/j.1464-5491.2006.01912.x
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发表时间：
2006-07-01
影响因子：
3.5
通讯作者：
Herrington, DM
中科院分区：
文献类型：
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作者：
Bowden, DW;Lohman, K;Herrington, DM
炎症性生物标志物，特别是C反应蛋白（CRP）水平的升高与心血管疾病（CVD）事件（如心肌梗死、中风、外周血管疾病和心源性猝死）的风险增加相关。增加CRP水平的医学干预措施，如绝经后妇女的激素替代疗法（HRT），正受到越来越多的关注。HRT对女性2型糖尿病（T2 DM）患者CRP水平的影响尚未得到很好的记录，并且报告了相互矛盾的结论。本研究的目的是确定HRT对女性糖尿病患者的影响在一个大的横断面study.Methods 327绝经后女性T2 DM糖尿病心脏研究参加。目前使用的HRT确定和血清CRP水平测定使用高灵敏度ELISA试剂盒。采用广义估计方程法分析多种临床和生活方式（如吸烟）指标与CRP水平的关系，包括HRT组（HRT+）和HRT-组（HRT-）的差异。结果血清CRP水平与体重指数（P < 0.0001）和年龄（P < 0.0001）密切相关。在这些妇女中，243人没有使用HRT，84人使用HRT。HRT+和HRT-妇女没有显着差异，在临床特征的措施，除了较高的平均低密度脂蛋白胆固醇在HRT-妇女（P = 0.004）。在所有模型中，HRT+妇女的循环CRP水平显著升高，P值范围为0.0045 ~ 0.010。结论在本研究中，HRT对2型糖尿病妇女的血清CRP浓度的影响，有一致的证据表明接受含雌激素HRT的妇女循环CRP水平升高。HRT诱导的CRP升高是否可以解释HRT的心血管不良反应仍有待确定;然而，根据这些数据，几乎没有理由相信糖尿病女性会免于这种影响。
Aims Increased levels of inflammatory biomarkers, especially C-reactive protein (CRP), are associated with increased risk for cardiovascular disease (CVD) events, such as myocardial infarction, stroke, peripheral vascular disease, and sudden cardiac death. Medical interventions that increase CRP levels, such as hormone replacement therapy (HRT) in post-menopausal women, are under increasing scrutiny. The effect of HRT on CRP levels in women with Type 2 diabetes (T2DM) is not well documented, and conflicting conclusions have been reported. The aim of this study was to determine the influence of HRT on women with diabetes in a large cross-sectional study.Methods Three hundred and twenty-seven post-menopausal women with T2DM from the Diabetes Heart Study participated. Current use of HRT was determined and serum CRP levels were measured using a high-sensitivity ELISA kit. Generalized estimating equation methods were used to assess the relationship of multiple clinical and lifestyle (e.g. smoking) measures on CRP levels including differences between women taking HRT (HRT+) and not taking HRT (HRT-).Results Overall serum CRP levels were strongly associated with body mass index (P < 0.0001) and age (P < 0.0001). Of the women, 243 were not using HRT and 84 were using HRT. HRT+ and HRT- women did not differ significantly in measures of clinical traits, with the exception of higher mean low-density lipoprotein cholesterol in HRT- women (P = 0.004). In all models tested, HRT+ women had significantly higher circulating CRP levels, with P-values ranging from 0.0045 to 0.010.Conclusions In this study of serum CRP concentration as a function of HRT in women with Type 2 diabetes, there was consistent evidence for increased circulating CRP levels in women receiving oestrogen-containing HRT. Whether HRT-induced increases in CRP can account for the adverse cardiovascular effects of HRT remains to be established; however, based on these data, there is little reason to believe that diabetic women would be spared from such an effect.