Endogenous postmenopausal hormones and carotid atherosclerosis: A case-control study of the atherosclerosis risk in communities cohort
Endogenous postmenopausal hormones and carotid atherosclerosis: A case-control study of the atherosclerosis risk in communities cohort
复制标题
DOI：
10.1093/aje/155.5.437
复制
发表时间：
2002-03-01
影响因子：
5
通讯作者：
Szklo, M
中科院分区：
文献类型：
--
作者：
Golden, SH;Maguire, A;Szklo, M
研究绝经后内源性激素水平和心血管疾病之间的关系产生了相互矛盾的结果。在排除了有激素替代疗法（HRT）使用史的女性后，作者在1987-1992年进行了一项美国病例对照研究，比较了社区动脉粥样硬化风险（ARIC）队列中有和无显著颈动脉粥样硬化的女性的内源性绝经后激素水平。采用B型超声测量颈动脉内膜中层厚度（IMT）评价动脉粥样硬化程度。病例（n = 182）为平均IMT测量值大于或等于第95百分位数的绝经后妇女。对照组（n = 182）与年龄和ARIC中心的病例频率匹配，IMT测量值<第75百分位数。在调整心血管危险因素后，没有发现动脉粥样硬化的几率与雌酮、硫酸脱氢表雄酮或雄烯二酮的四分位数增加之间存在关联。与性激素结合球蛋白（SHBG）最低四分位数的参与者相比，最高四分位数的参与者患动脉粥样硬化的几率显著较低（比值比= 0.48，95%置信区间：0.24，0.97）。同样，总睾酮水平最高四分位数的参与者患动脉粥样硬化的几率较低（比值比= 0.38，95%置信区间：0.20，0.74）。作者发现较高的总睾酮和SHBG与颈动脉粥样硬化呈负相关，表明它们在降低未使用HRT的绝经后妇女动脉粥样硬化风险方面的潜在重要性。
Studies examining the relation between endogenous postmenopausal hormone levels and cardiovascular disease have yielded conflicting results. After excluding women with a history of hormone replacement therapy (HRT) use, the authors conducted a US case-control study in 1987-1992 comparing endogenous postmenopausal hormone levels in women with and without significant carotid atherosclerosis in the Atherosclerosis Risk in Communities (ARIC) cohort. Atherosclerosis was assessed by using B-mode ultrasound to measure carotid artery intimal-medial thickness (IMT). Cases (n = 182) were postmenopausal women with average IMT measurements greater than or equal to the 95th percentile. Controls (n = 182) were frequency matched to cases on age and ARIC center and had IMT measurements < the 75th percentile. After adjustment for cardiovascular risk factors, no association was found between the odds of atherosclerosis and increasing quartiles of estrone, dehydroepiandrosterone sulfate, or androstenedione. Compared with participants in the lowest quartile of sex hormone-binding globulin (SHBG), those in the highest quartile had a significantly lower odds of atherosclerosis (odds ratio = 0.48, 95% confidence interval: 0.24, 0.97). Similarly, participants in the highest quartile of total testosterone had a lower odds of atherosclerosis (odds ratio = 0.38, 95% confidence interval: 0.20, 0.74). The authors found higher total testosterone and SHBG to be inversely related to carotid atherosclerosis, suggesting their potential importance in reducing atherosclerotic risk in postmenopausal women not using HRT.