Atherosclerosis-related biomarkers in women with endometriosis: The effects of dienogest and oral contraceptive therapy
Atherosclerosis-related biomarkers in women with endometriosis: The effects of dienogest and oral contraceptive therapy
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DOI：
10.1016/j.eurox.2020.100108
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发表时间：
2020-07-01
期刊：
影响因子：
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通讯作者：
Kitawaki, Jo
中科院分区：
文献类型：
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作者：
Maeda, Eiko;Koshiba, Akemi;Kitawaki, Jo
目的：子宫内膜异位症的慢性炎症与未来心血管疾病的风险增加有关;然而，没有研究调查过子宫内膜异位症接受激素治疗的妇女的心血管风险。我们调查了动脉粥样硬化相关的生物标志物在妇女和子宫内膜异位症和地诺孕素（DNG）和口服避孕药（OC）therapeutic.Study design的影响：在这个横断面研究中，109名妇女子宫内膜异位症和42名对照妇女没有子宫内膜异位症。子宫内膜异位症组分为未治疗组（n = 34）、DNG治疗组（n = 33）和OC治疗组（n = 42）。结果：DNG组中位治疗时间为28个月，OC组中位治疗时间为32.5个月，DNG组中位治疗时间为28个月，OC组中位治疗时间为32.5个月。OC组甘油三酯水平高于其他3组（P < 0.05）。关于炎症和氧化应激的标志物，未治疗组的log高敏C-反应蛋白和二缩酮-活性氧代谢产物水平高于对照组（P < 0.05），OC组上述指标进一步升高（log高敏C-反应蛋白：P < 0.05;双曲酮-活性氧代谢产物：P < 0.01），但DNG组无此变化。CAVI和ABI在各组间无差异。斯皮尔曼相关分析显示OC治疗持续时间与CAVI呈正相关（rho = +0.49; P = 0.002），而DNG治疗持续时间与CAVI无相关性（rho = -0.04; P = 0.81）。用OC而不是DNG处理进一步增加了这些水平。对于子宫内膜异位症患者，OC给药持续时间与动脉粥样硬化风险呈正相关。我们的研究结果表明，DNG可以用于子宫内膜异位症，而不会增加动脉粥样硬化的风险，短期OC用于子宫内膜异位症是无害的，但应严格观察动脉粥样硬化的风险。(c)2020作者（S）由爱思唯尔公司出版。这是一篇开放获取的文章，获得了CC BY-NC-ND许可证（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
Objective: Chronic inflammation in endometriosis is associated with increased risk of future cardiovascular disease; however, no studies have investigated the cardiovascular risk of women who have undergone hormonal therapy for endometriosis. We investigated atherosclerosis-related biomarkers in women with and without endometriosis and the effects of dienogest (DNG) and oral contraceptive (OC) therapies.Study design: In this cross-sectional study, 109 women with endometriosis and 42 control women without endometriosis were enrolled. The endometriosis group was divided into the untreated (n = 34), DNG therapy (n = 33), and OC therapy (n = 42) groups. Lipid profile serum levels, inflammatory marker such as high-sensitivity C-reactive protein, oxidative stress markers such as oxidized low-density lipoprotein and diacron-reactive oxygen metabolites, and atherosclerosis indicators (cardio-ankle vascular index [CAVI] and ankle-brachial pressure index [ABI]) were measured.Results: The median treatment duration was 28 months in the DNG group and 32.5 months in the OC group. Triglyceride levels were higher in the OC group than in the other three groups (P < 0.05). Regarding markers of inflammation and oxidative stress, log high-sensitivity C-reactive protein and diacron-reactive oxygen metabolites levels were higher in the untreated group than in the control group (P < 0.05), and these markers were further increased in the OC group (log high-sensitivity C-reactive protein: P < 0.05; diacron-reactive oxygen metabolites: P < 0.01), but not in the DNG group. There was no difference in the CAVI and ABI among all groups. Spearman correlation revealed a positive correlation between duration of OC therapy and CAVI (rho = +0.49; P = 0.002), but no correlation between the duration of DNG therapy and CAVI (rho = -0.04; P = 0.81).Conclusions: Inflammation and oxidative stress markers are increased in women with untreated endometriosis. Treatment with OC, but not with DNG, further increases these levels. There was a positive association between the duration of OC administration and atherosclerosis risk for women with endometriosis. Our results suggest that DNG could be administered to endometriosis without the increased atherosclerosis risk and short-term OC administration for endometriosis is not harmful, however, atherosclerosis risk should be strictly observed. (c) 2020 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).