Tibolone, transdermal estradiol or oral estrogen–progestin therapies: Effects on circulating allopregnanolone, cortisol and dehydroepiandrosterone levels
Tibolone, transdermal estradiol or oral estrogen–progestin therapies: Effects on circulating allopregnanolone, cortisol and dehydroepiandrosterone levels
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替勃龙、透皮雌二醇或口服雌激素-孕激素疗法：对循环四氢孕酮、皮质醇和脱氢表雄酮水平的影响
DOI：
10.1080/09513590400021169
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发表时间：
2005
影响因子：
2
通讯作者：
A. Genazzani
中科院分区：
文献类型：
--
作者：
N. Pluchino;A. Genazzani;F. Bernardi;E. Casarosa;M. Pieri;M. Palumbo;G. Picciarelli;M. Gabbanini;M. Luisi;A. Genazzani
本研究的目的是评估健康绝经后妇女中，替勃龙（2.5 mg）、经皮雌二醇（50 μ g）（TE）和不同口服雌激素-炔雌醇方案、结合马雌激素（0.625 mg）加醋酸甲羟孕酮（5 mg）（CEE + MPA）和雌二醇（2 mg）加醋酸炔诺酮（1 mg）（E2 + NETA）对循环雌二醇、孕酮、别孕烯醇酮、皮质醇和脱氢表雄酮（DHEA）水平的影响。 在85名绝经后妇女中，在治疗前和治疗后1、3、6和9个月收集血液样品。治疗1个月后，TE、CEE + MPA和E2 + NETA组中的雌二醇水平增加（p <0.001），但在整个随访期间，替勃龙组中的雌二醇水平没有变化。 治疗1年后，E2 + NETA和替勃龙治疗均诱导孕酮水平升高（p <0.05）。 别孕烯醇酮水平在所有基于雌激素的组中显示出增加，在治疗3个月后显著（p <0.01）。 接受替勃龙的患者在3个月时显示出别孕烯醇酮水平的显著增加（p <0.05），但低于其他组。 TE组和CEE + MPA组分别在治疗6个月和12个月后皮质醇水平显著降低。 无论是替勃龙，也没有E2 + NETA治疗修改循环皮质醇水平。 在TE或雌激素-孕酮治疗6个月后，DHEA水平显著降低（p <0.05），与孕酮的存在或使用的孕酮类型无关。 相反，DHEA在用替勃龙治疗的12个月期间保持稳定。增加allopregnanolone，类固醇与镇静和抗焦虑的特性，在响应这些不同的治疗可能是基础，至少部分，激素替代疗法和替勃龙对焦虑，情绪和行为的中心作用。与雌激素为基础的治疗，替勃龙治疗并没有减少DHEA环境在绝经期，因此并没有提高雄激素缺乏综合征绝经后妇女。
The aim of the present study was to evaluate, in healthy postmenopausal women, the impact of tibolone (2.5 mg), transdermal estradiol (50 μg) (TE) and different oral estrogen–progestin regimens, conjugated equine estrogens (0.625 mg) plus medroxyprogesterone acetate (5 mg) (CEE + MPA) and estradiol (2 mg) plus norethisterone acetate (1 mg) (E2 + NETA) on circulating estradiol, progesterone, allopregnanolone, cortisol and dehydroepiandrosterone (DHEA) levels. Blood samples were collected before and after 1, 3, 6 and 9 months of treatment in 85 postmenopausal women. Estradiol levels increased (p < 0.001) in the TE, CEE + MPA and E2 + NETA groups after 1 month of therapy, but did not change in the tibolone group during the entire follow-up period. Both E2 + NETA and tibolone treatments induced an increase in progesterone levels (p < 0.05) after 1 year of therapy. Allopregnanolone levels showed an increase in all estrogen-based groups, being significant after 3 months of treatment (p < 0.01). Patients receiving tibolone showed a significant increase in allopregnanolone levels at 3 months (p < 0.05), but lower than in the other groups. Cortisol levels decreased significantly in the TE and CEE + MPA groups after 6 months and 12 months of treatment, respectively. Neither tibolone nor E2 + NETA treatments modified circulating cortisol levels. DHEA levels significantly (p < 0.05) decreased after 6 months of TE or estrogen–progestin therapies independently of the presence or the type of progestin used. In contrast, DHEA remained stable throughout the 12 months of treatment with tibolone. The increase of allopregnanolone, a steroid with sedative and anxiolytic properties, in response to these different treatments could underlie, at least in part, the central effects that hormone replacement therapy and tibolone have on anxiety, mood and behavior. Unlike estrogen-based therapy, tibolone treatment did not reduce the DHEA milieu in the menopause, and thus did not enhance the androgen deficiency syndrome in postmenopausal women.
神经类固醇：生物化学、作用方式和临床相关性。
DOI：
10.1210/jcem.78.5.8175951
发表时间：
1994
期刊：
The Journal of clinical endocrinology and metabolism
影响因子：
--
作者：
Mellon,SH
通讯作者：
Mellon,SH
3 α-羟基类固醇脱氢酶：三维结构和基因调控。
DOI：
--
发表时间：
1996
期刊：
The Journal of endocrinology.
影响因子：
--
作者：
Penning,TM
通讯作者：
Penning,TM