Prior to use of estrogen replacement therapy, are users healthier than nonusers?
Prior to use of estrogen replacement therapy, are users healthier than nonusers?
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在使用雌激素替代疗法之前，使用者比未使用者更健康吗？
DOI：
10.1093/oxfordjournals.aje.a008678
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发表时间：
1996
影响因子：
5
通讯作者：
Plantinga,P
中科院分区：
文献类型：
--
作者：
Matthews,KA;Kuller,LH;Wing,RR;Meilahn,EN;Plantinga,P
观察性研究表明，绝经后使用雌激素替代疗法（ERT）的妇女患冠心病的风险降低。作者研究了绝经前妇女在绝经期间选择使用ERT后，其心血管危险因素的特征是否优于未使用者。共有541名绝经前妇女在进入研究时评估了心血管危险因素和心理社会特征。大约8年后，355名妇女绝经，157名妇女在随访期间报告使用ERT（平均= 93.4个月）。作者比较了使用者与非使用者的绝经前特征。相对于非使用者，ERT使用者受教育程度更高（63%对81%，至少有一些大学），并且在使用ERT之前，高密度脂蛋白（HDL）胆固醇水平较高（1.49与1.59 mmol/L），HDL 2（0.50与0.57 mmol/L），HDL 3（0.98与1.02 mmol/L），休闲体力活动（5，122千焦耳对7，158千焦耳），以及酒精摄入量（7.5 vs 9.7 g/天），载脂蛋白B水平较低（0.97与0.90 g/L），收缩压（112.1 vs. 107.1 mmHg）和舒张压（73.8 vs. 71.4 mmHg）、体重（68.5 vs. 64.2 kg）和空腹胰岛素（9.10 vs. 7.66 μU/L）。在使用ERT之前，与非使用者相比，随后的使用者在标准化问卷中报告说，他们更经常表现出A型行为，更了解自己的感受、动机和症状，并有更多的压力症状。选择使用ERT的女性在使用ERT前的心血管风险因素特征优于随后在绝经期不使用该治疗的女性，这支持了以下假设：与使用ERT相关的部分明显获益是由于使用ERT的女性的既存特征。这项研究强调了随机临床试验的重要性，以评估绝经后雌激素替代治疗对保护妇女免受心血管疾病的直接益处。
Observational studies have demonstrated that women who have used postmenopausal estrogen replacement therapy (ERT) are at reduced risk of coronary heart disease. The authors examined whether premenopausal women who subsequently elected to use ERT during menopause had a better cardiovascular risk factor profile prior to use than did nonusers. A total of 541 premenopausal women had their cardiovascular risk factors and psychosocial characteristics evaluated at study entry. After approximately 8 years, 355 women had become postmenopausal, and 157 women reported ERT use during the follow-up period (mean = 93.4 months). The authors compared the premenopausal characteristics of users with those of nonusers. Relative to nonusers, ERT users were better educated (63 vs. 81 % with at least some college), and prior to the use of ERT had higher levels of high density lipoprotein (HDL) cholesterol (1.49 vs. 1.59 mmol/liter), HDL2 (0.50 vs. 0.57 mmol/liter), HDL3 (0.98 vs. 1.02 mmol/liter), leisure physical activity (5, 122 vs. 7, 158 Kjoules), and alcohol intake (7.5 vs. 9.7 g/day), and lower levels of apolipoprotein B (0.97 vs. 0.90 g/liter), systolic blood pressure (112.1 vs. 107.1 mmHg) and diastolic blood pressure (73.8 vs. 71.4 mmHg), weight (68.5 vs. 64.2 kg), and fasting insulin (9.10 vs. 7.66 μU/liter). Prior to use of ERT, in comparison with nonusers, subsequent users reported on standardized questionnaires that they more often exhibited Type A behavior, were more aware of their feelings, motives, and symptoms, and had more symptoms of stress. Women who elect to use ERT have a better cardiovascular risk factor profile prior to the use of ERT than do women who subsequently do not use this treatment during the menopause, which supports the hypothesis that part of the apparent benefit associated with use of ERT is due to preexisting characteristics of women who use ERT. This study underscores the widely recognized importance of randomized clinical trials to estimate the direct benefit of postmenopausal ERT for protecting women from cardiovascular disease.