Factors Associated With Serum Estradiol Levels Among Postmenopausal Women Using Hormone Therapy.
Factors Associated With Serum Estradiol Levels Among Postmenopausal Women Using Hormone Therapy.
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DOI：
10.1097/aog.0000000000004006
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发表时间：
2020-10
影响因子：
7.2
通讯作者：
Mack WJ
中科院分区：
文献类型：
--
作者：
Sriprasert I;Kono N;Karim R;Hodis HN;Stanczyk FZ;Shoupe D;Mack WJ
确定与使用激素治疗（HT）的健康绝经后妇女血清雌二醇（E2）水平相关的因素。这是一项计划外的事后分析，数据来自E2早期与晚期干预试验，这是一项在健康绝经后妇女中进行的1 mg口服E2联合或不联合阴道孕酮的随机对照试验。我们纳入了当女性报告至少80%的HT依从性时的访视结果。混合效应线性模型确定了与服用HT时血清E2水平相关的因素，在中位随访4.8年期间每6个月评估一次，根据基线E2水平、访视和降低的E2剂量进行调整。评价的可能相关性包括人口统计学、临床特征、药物使用和肝肾代谢功能的生物标志物。该分析包括2160 E2测量275绝经后妇女。早期与晚期绝经后女性的平均±SD年龄分别为55.4±3.9岁与64.4±5.5岁，平均±SD绝经后时间分别为3.6±1.8岁与16.0±5.6岁。校正治疗前E2水平、访视和减少剂量指标后，血清E2水平较高与体重指数（BMI）较高、体重较高、手术绝经、饮酒和抗高血压药物使用相关。目前和过去的吸烟和抗真菌药物的使用与血清E2水平较低。在多变量模型中，较高的BMI和饮酒与较高的血清E2水平相关，而当前和过去吸烟与较低的血清E2水平相关。这些因素在绝经早期和晚期妇女之间相似。与服用HT的绝经后妇女血清E2水平相关的因素包括BMI、饮酒和吸烟。由于血清E2水平与HT效应有关，因此可以通过个性化干预最大限度地提高E2水平。ClinicalTrials.gov，NCT00114517。在接受激素治疗的绝经后妇女中，体重指数、饮酒和吸烟与血清雌二醇水平相关。
To identify factors associated with serum estradiol (E2) levels among healthy postmenopausal women using hormone therapy (HT). This is an unplanned post hoc analysis of data from the Early versus Late Intervention Trial with Estradiol, a randomized controlled trial of 1 mg oral E2 with or without vaginal progesterone in healthy postmenopausal women. We included results from visits when women reported at least 80% compliance to HT. Mixed effects linear models identified factors associated with serum E2 levels while taking HT assessed every 6 months over a median follow-up of 4.8 years adjusted for baseline E2 level, visit and reduced E2 dose. Possible correlates evaluated included demographics, clinical characteristics, medication use and biomarkers of liver and kidney metabolic function. The analysis included 2160 E2 measurements in 275 postmenopausal women. Mean±SD age was 55.4±3.9 vs 64.4±5.5 years and mean±SD time-since-menopause was 3.6±1.8 vs 16.0±5.6 years for early vs late postmenopausal women. Adjusted for pre-treatment E2 level, visit and reduced dose indicator, higher serum E2 levels were associated with higher body mass index (BMI), higher weight, surgical menopause, alcohol use, and antihypertensive medication use. Current and past smoking and antifungal medication use were associated with lower serum E2 levels. In the multivariable model, higher BMI and alcohol use were associated with higher serum E2 levels while current and past smoking were associated with lower serum E2 levels. These factors were similar between early and late postmenopausal women. Factors associated with serum E2 levels among postmenopausal women taking HT include BMI, alcohol use and smoking. As serum E2 levels relate to HT effect, achievement of desirable E2 levels can be maximized through personalized intervention. ClinicalTrials.gov, NCT00114517. Body mass index, alcohol use, and smoking are associated with serum estradiol levels among postmenopausal women taking hormone therapy.