Effects of hormone therapy on soluble cell adhesion molecules in postmenopausal women with coronary artery disease.
Effects of hormone therapy on soluble cell adhesion molecules in postmenopausal women with coronary artery disease.
复制标题
激素治疗对患有冠状动脉疾病的绝经后妇女可溶性细胞粘附分子的影响。
DOI：
10.1097/gme.0b013e31816d8171
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Herrington,DavidM
中科院分区：
文献类型：
--
作者：
Yeboah,Joseph;Klein,Karen;Brosnihan,Bridget;Reboussin,David;Herrington,DavidM
目的：尽管观察性研究显示接受激素治疗（HT）的绝经后妇女缺血性冠心病风险明显降低，但绝经后妇女的随机临床试验显示缺血性心血管事件增加。可溶性细胞粘附分子与心血管危险因素和事件相关。HT可降低健康绝经后妇女的可溶性细胞粘附分子循环水平，但其对绝经后冠心病妇女的影响尚不清楚。我们评估了HT对可溶性细胞粘附分子在雌激素替代品和Atherapeutic trial.Design的影响：雌激素替代品和Atherapeutic trial是一项双盲，安慰剂对照研究，随机309绝经后妇女（平均年龄，65.8岁），每日unopposed雌激素（结合雌激素0.625毫克），雌激素加2.5毫克的醋酸甲羟孕酮，或安慰剂，平均随访期为3.2年。可溶性细胞间粘附分子-1，血管细胞粘附分子-1，E-选择素测定血清中获得的参与者在基线和12个月后的follow-up.Results：265名妇女的完整数据，87名妇女被分配到unconvicted雌激素，88名妇女的雌激素加醋酸甲羟孕酮，和90名妇女安慰剂。与安慰剂相比，12个月的HT（n= 175）与可溶性细胞间粘附分子-1的降低相关（25.6±4.7 vs 10.6±6.4 ng/mL，P= 0.06），可溶性血管细胞粘附分子-1（80.2±10.6 vs 28.8±14.7 ng/mL，P= 0.005）和E-选择素（8.8±0.9 vs− 1.1±1.2 ng/mL，P< 0.001）。结论：确诊冠心病的绝经后妇女HT 12个月与内皮细胞活化/损伤的血清标志物如可溶性细胞间粘附分子-1、血管细胞粘附分子-1和E-选择素的降低有关。
Objective:Although observational studies showed an apparent lower ischemic coronary disease risk in postmenopausal women receiving hormone therapy (HT), randomized clinical trials in postmenopausal women showed an increase in ischemic cardiovascular events. Soluble cell adhesion molecules have been associated with cardiovascular risk factors and events. HT reduces circulating levels of soluble cell adhesion molecules in healthy postmenopausal women, but its effects in postmenopausal women with coronary artery disease are less clear. We assessed the effect of HT on soluble cell adhesion molecules in the Estrogen Replacement and Atherosclerosis trial.Design:The Estrogen Replacement and Atherosclerosis trial was a double-blind, placebo-controlled study that randomized 309 postmenopausal women (mean age, 65.8 y) to daily unopposed estrogen (conjugated estrogens 0.625 mg), estrogen plus 2.5 mg of medroxyprogesterone acetate, or placebo, with a mean follow-up period of 3.2 years. Soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin were measured in serum obtained from participants at baseline and after 12 months of follow-up.Results:Of the 265 women with complete data, 87 women were assigned to unopposed estrogen, 88 women to estrogen plus medroxyprogesterone acetate, and 90 women to placebo. Compared with placebo, 12 months of HT (n= 175) was associated with reductions in soluble intercellular adhesion molecule-1 (25.6±4.7 vs 10.6±6.4 ng/mL, P= 0.06), soluble vascular cell adhesion molecule-1 (80.2±10.6 vs 28.8±14.7 ng/mL, P= 0.005), and E-selectin (8.8±0.9 vs− 1.1±1.2 ng/mL, P< 0.001).Conclusions:Twelve months of HT in postmenopausal women with established coronary artery disease was associated with reductions in serum markers of endothelial cell activation/injury such as soluble intercellular adhesion molecule-1, vascular cell adhesion molecule-1, and E-selectin.