Change in metabolic parameters and reproductive hormones from baseline to 6-month hormone therapy.
Change in metabolic parameters and reproductive hormones from baseline to 6-month hormone therapy.
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从基线到 6 个月激素治疗的代谢参数和生殖激素的变化
DOI：
10.1097/md.0000000000028361
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发表时间：
2022-01-07
期刊：
影响因子：
1.6
通讯作者：
Zhou J
中科院分区：
文献类型：
--
作者：
Qi T;Wang X;Huang Y;Song Y;Ma L;Ying Q;Chatooah ND;Lan Y;Chen P;Xu W;Chu K;Ruan F;Zhou J
摘要有充分的证据表明，激素治疗（HT）通过降低空腹血糖和胰岛素降低中年妇女新发糖尿病的风险。然而，这些糖尿病生物标志物的改善在临床观察中因个体而异。本研究的目的是探讨与HT期间空腹血糖和胰岛素变化相关的潜在基线因素。在263名年龄在40至60岁之间的中年参与者中进行了一项回顾性队列研究，这些参与者接受了6个月的个体化HT治疗。 在基线和随访时收集和测量人口学信息和实验室指标，包括生殖激素、血脂谱、糖尿病指标。进行了一系列统计分析，以确认HT的有效性，并比较不同血糖或胰岛素反应的参与者之间的基线因素。进一步采用逐步变量选择的多元线性回归模型分析影响空腹血糖和胰岛素变化的相关因素。在所有参与者中，个体化HT后空腹血糖（P= 0.001）和空腹胰岛素（P <0.001）显著降低。 在对HT有不同血糖反应的参与者中，观察到基线生殖激素的显著差异（促卵泡激素[FSH]和雌二醇均P<0.001）。 逐步线性回归模型显示，除基线空腹血糖水平外，基线FSH也与空腹血糖变化独立相关（基线FSHβ =-0.145，P = 0.019），但与空腹胰岛素无关。 尽管FSH水平较高的女性已经处于较好的代谢状态，但她们的空腹血糖下降幅度更大（P = 0.037）。 基线FSH水平较高的中年妇女空腹血糖下降幅度较大，但空腹胰岛素下降幅度较小。FSH可能是绝经后和绝经后妇女对HT的血糖反应的独立预测因子。
Abstract Adequate evidence showed hormone therapy (HT) reduces the risk of new-onset diabetes in midlife women by decreasing fasting glucose and insulin. However, the improvement of these diabetic biomarkers varied with each individual in clinical observations. The objective of our study was to investigate potential baseline factors associated with the change of fasting glucose and insulin during HT. A retrospective cohort study was performed among 263 midlife participants aged 40 to 60 years with menopausal symptoms who have received 6-month individualized HT. Demographic information and laboratory indicators including reproductive hormone, lipid profiles, diabetic indicators were collected and measured at baseline and were followed-up. A series of statistical analyses were performed to confirm the effectiveness of HT and compare the baseline factors between participants with different glycemic or insulinemic response. Multivariable linear regression model with stepwise variable selection was further used to identify the associated factor with the change of fasting glucose and insulin. Of all participants, fasting glucose (P = .001) and fasting insulin (P < .001) were significantly decreased after individualized HT. Significant differences in baseline reproductive hormones were observed in participants with different glycemic response to HT (P < .001 for both follicle stimulating hormone [FSH] and estradiol). Stepwise linear regression model showed that in addition to baseline fasting glucose levels, baseline FSH was also independently associated with the change of fasting glucose (β = −0.145, P = .019 for baseline FSH) but not fasting insulin. Greater reduction in fasting glucose in women with higher FSH levels was observed even though they have already been in better metabolic conditions (P = .037). Midlife women with higher baseline FSH levels have greater reduction in fasting glucose but not fasting insulin. FSH could be an independent predictor of glycemic response to HT in peri- and postmenopausal women.