Rhythmic Fluctuations in Levels of Liver Enzymes During Menstrual Cycles of Healthy Women and Effects of Body Weight.
Rhythmic Fluctuations in Levels of Liver Enzymes During Menstrual Cycles of Healthy Women and Effects of Body Weight.
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健康女性月经周期期间肝酶水平的节律波动和体重的影响。
DOI：
10.1016/j.cgh.2019.11.047
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Rotman,Yaron
中科院分区：
文献类型：
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作者：
Lai,ChunweiWalter;Jadhav,Sneha;Njei,Basile;Ye,Aijun;Wactawski-Wende,Jean;Mumford,SunniL;Schisterman,EnriqueF;Rotman,Yaron
背景与目的女性性激素影响一些非生殖器官，但在正常月经周期中对肝脏的影响知之甚少。我们的目的是调查性激素和肝酶在健康经期妇女之间的关系。方法：我们对bicycle研究的数据进行了事后分析，这是一项纵向队列研究，旨在确定性激素与月经周期中氧化应激标志物的关系。我们分析了从259名经期妇女收集的数据，这些妇女在1-2个月经周期内进行了多达16次单独的办公室访问，这些访问由生育监视器定时。肝酶水平，包括丙氨酸转氨酶（ALT）、天冬氨酸转氨酶、碱性磷酸酶（ALKP）、胆红素和脂质通过实验室测定。结果肝酶呈自然循环模式，转氨酶和碱性磷酸酶在卵泡中期达到峰值，在黄体晚期达到低谷；ALT的峰谷差为4.0±4.9 U/L， ALKP的峰谷差为8.8±4.0 U/L。ALT水平与术前黄体酮水平呈显著负相关（P = 5 × 10-4），而ALKP水平与雌激素（P = 0.007）和黄体酮（P = 1 × 10-11）呈显著负相关。食物和酒精的摄入并没有改变这种联系。非裔美国人谷丙转氨酶的波动幅度更大，并随着年龄的增长而下降。在体重指数为30 kg/m2的女性中，ALT水平的波动较小（P = 0.03）。在月经波动期间，49%的参与者ALT值高于或低于正常临界值（19 U/L）。结论正常月经周期肝酶水平波动可能与孕激素有关，且随年龄和体重指数的变化而变化。这些发现表明，在解释经期妇女肝酶测量时，考虑月经周期阶段的重要性。
Background & AimsFemale sex hormones affect several non-reproductive organs, but little is known about their effects on the liver during a normal menstrual cycle. We aimed to investigate the association between sex hormones and liver enzymes in healthy menstruating women.MethodsWe performed a post-hoc analysis of data from the BioCycle study, a longitudinal cohort study designed to determine the association of sex hormones with markers of oxidative stress during the menstrual cycle. We analyzed data collected from 259 menstruating women, over 1–2 menstrual cycles, who had as many as 16 separate office visits, timed by fertility monitors. Levels of liver enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase, and alkaline phosphatase (ALKP), bilirubin, and lipids were measured by laboratory assays.ResultsWe found a natural cyclic pattern for liver enzymes, with transaminases and ALKP peaking in the mid-follicular phase and reaching a trough in the late luteal phase; the peak to trough differences were 4.0 ± 4.9 U/L for ALT and 8.8 ± 4.0 U/L for ALKP. Levels of ALT were significantly and negatively associated with levels of progesterone on the preceding visit (P = 5x10-4), whereas level of ALKP was negatively associated with level of estrogen (P = .007) and progesterone (P = 1x10-11). Food and alcohol intake did not modify the association. The amplitude of ALT fluctuation was greater in African Americans and decreased with age. Fluctuations in levels of ALT were smaller in women with body mass indices >30 kg/m2(P = .03). During menstrual fluctuation, 49% of participants had ALT values both above and below the normal cut-off value (19 U/L).ConclusionsLevels of liver enzymes fluctuate during the normal menstrual cycle, possibly mediated by progesterone, and the fluctuation varies with age and body mass index. These findings indicate the importance of accounting for phase of menstrual cycle when interpreting liver enzyme measurements in menstruating women.