Levels of sex steroid and cardiovascular disease measures in premenopausal and hormone-treated women at midlife: implications for the "timing hypothesis".
Levels of sex steroid and cardiovascular disease measures in premenopausal and hormone-treated women at midlife: implications for the "timing hypothesis".
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DOI：
10.1001/archinte.168.19.2146
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发表时间：
2008-10-27
影响因子：
--
通讯作者：
McConnell, Daniel
中科院分区：
文献类型：
--
作者：
Sowers, MaryFran R.;Randolph, John, Jr.;Jannausch, Mary;Lasley, Bill;Jackson, Elizabeth;McConnell, Daniel
根据妇女健康倡议试验的发现，“时间假设”表明，激素治疗（HT）的使用应该在绝经过渡的六年内开始，以延长绝经后有利的雌激素环境。我们在以社区为基础的更年期过渡纵向研究（全国妇女健康研究）中比较了第05次就诊时的性类固醇和心血管特征。年龄47-57岁的女性分为四组：绝经前，使用结合马雌激素（CEE）加或不加黄体酮，或绝经后（<5年）。心血管检测包括低密度脂蛋白胆固醇（LDL-c）、氧化LDL-c、高密度脂蛋白胆固醇（HDL-c）、甘油三酯、载脂蛋白a -1和B、f2a -异前列腺素、c反应蛋白（CRP）和脂蛋白(a)-1。性类固醇检测包括雌二醇（E2）、雌激素受体配体负荷（ERLL）、2-羟孕酮（2-OHE1）、16α-羟孕酮（16α-OHE1）、总睾酮和性激素结合球蛋白（SHBG）。激素使用者的SHBG水平比绝经前或绝经后妇女高50%（两组均p<0.0001），这限制了性类固醇与受体的结合，并且排泄的雌酮代谢物比绝经前或绝经后妇女高（超过60%，两组均p<0.0001）。反过来，与绝经前妇女相比，这些与更高的f2a -异前列腺素（一种氧化应激指标）有关。HT使用者的HDL-c/LDL-c比值高于绝经前或绝经后妇女（p<0.01），但甘油三酯水平较高（p<0.01）。虽然激素使用者比绝经前和绝经后的妇女有更有利的脂质谱，但有证据表明，即使在没有动脉粥样硬化的妇女中，在“时间假设”提出的大约6年的时间内，激素也会产生不良影响。
The “timing hypothesis”, in addressing findings from the Women’s Health Initiative trial, suggests that hormone therapy (HT) use should be initiated within six years of the menopause transition to extend a favorable estrogenic environment after menopause. We compared sex steroid and cardiovascular profiles at visit 05 in a community-based, longitudinal study of the menopause transition (Study of Women’s Health Across the Nation). Women, aged 47–57 years, were in one of four groups: premenopausal, using conjugated equine estrogen (CEE) with or without progestin, or postmenopausal (<5 years). Cardiovascular assays included low density lipoprotein cholesterol (LDL-c), oxidized LDL-c, high density lipoprotein cholesterol (HDL-c), triglycerides, apolipoproteins A-1 and B, F2a-isoprostanes, C-reactive protein (CRP), and lipoprotein(a)-1. Sex steroid assays were for estradiol (E2), estrogen receptor ligand load (ERLL), 2-hydroxyestrone (2-OHE1), 16α-hydroxyestrone (16α-OHE1), total testosterone, and sex hormone-binding globulin (SHBG). HT users had 50% higher SHBG levels (p<0.0001 for both groups), which limits sex steroids binding to their receptors, and higher excreted estrone metabolites (more than 60%, p<0.0001 for both groups) than pre- or postmenopausal women. These were, in turn, associated with higher F2a-isoprostanes, an oxidative stress measure, compared to premenopausal women. HT users had a more favorable HDL-c/LDL-c ratio than pre- or postmenopausal women (p<0.01), but higher triglyceride levels (p<0.01). Though HT users had some more favorable lipid profiles than pre- and postmenopausal women, there was evidence of adverse HT effects even in women free of atherosclerosis evaluated within the approximate 6-year time period proposed with the “timing hypothesis”.
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DOI：
10.3109/13697139809080677
发表时间：
1998-03-01
期刊：
Climacteric : the journal of the International Menopause Society
影响因子：
--
作者：
Dudley, E C;Hopper, J L;Dennerstein, L
通讯作者：
Dennerstein, L
影响因子：
39.2
作者：
Grady, D;Wenger, NK;Hulley, S
通讯作者：
Hulley, S
影响因子：
10.4
作者：
Natarajan K;Overstreet JW;Rogers JM;Denison MS;Chen J;Lohstroh PN;McConnell DS;Lasley BL
通讯作者：
Lasley BL
影响因子：
2.7
作者：
KLUG, TL;BRADLOW, HL;SEPKOVIC, DW
通讯作者：
SEPKOVIC, DW
影响因子：
4.8
作者：
Sotiriou, SN;Orlova, VV;Chavakis, T
通讯作者：
Chavakis, T