EARLY MENARCHE, A RISK FACTOR FOR BREAST-CANCER, INDICATES EARLY ONSET OF OVULATORY CYCLES
EARLY MENARCHE, A RISK FACTOR FOR BREAST-CANCER, INDICATES EARLY ONSET OF OVULATORY CYCLES
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DOI：
10.1210/jcem-57-1-82
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发表时间：
1983-01-01
影响因子：
5.8
通讯作者：
VIHKO, R
中科院分区：
文献类型：
--
作者：
APTER, D;VIHKO, R
研究了初潮年龄和青春期月经周期激素模式之间的关系，以获得关于为什么初潮早期是乳腺癌的重要危险因素的信息。初始组200名女生，7-17岁，纵向调查3次，间隔1.5年。认为在周期后期血清孕酮浓度超过6.4 nmol/l（2.0 ng/ml）表示排卵周期，浓度< 1.6 nmol/l（0.5 ng/ml）表示无排卵周期。月经初潮时间和初潮年龄对排卵频率有显著影响（P < 0.001）。月经初潮早与排卵周期早相关。从月经初潮到50%的周期排卵的时间为约初潮年龄< 12.0岁、12.0-12.9岁、≥ 12.0岁时，分别为1岁、3岁、4.5岁。13.0 yr，分别。初潮年龄低于12.0岁的女孩有较高的血清雌二醇，但较低的睾酮和脱氢表雄酮浓度比月经初潮较晚的主题。在随访期间显示初潮早的受试者中，雌二醇与脱氢表雄酮的比率在初潮前就已经较高。肾上腺雄激素分泌的增加主要与实际年龄有关，不受初潮时间的影响。早期月经初潮后早期排卵的证明与雌激素窗口假说相冲突，该假说认为无排卵周期持续时间较长，可以解释早期月经初潮后乳腺癌风险增加。因此，应考虑其他理论，其中包括以下理论：青春期血清孕酮浓度高与血清雌二醇正常或高相关会增加风险，只有早期和相对较高的雌激素浓度很重要，或者雌激素与雄激素的比例是关键因素，雄激素具有保护作用。
The associations between age at menarche and the hormonal patterns of adolescent menstrual cycles were investigated to obtain information as to why early menarche is an important risk factor for breast cancer. An initial group of 200 schoolgirls, 7-17 yr old, was investigated longitudinally 3 times at 1.5 yr intervals. A serum progesterone concentration in the latter part of the cycle exceeding 6.4 nmol/l (2.0 ng/ml) was considered to signify an ovulatory cycle, and a concentration < 1.6 nmol/l (0.5 ng/ml) an anovulatory cycle. The frequency of ovulation depended significantly on both the time since menarche and the age at menarche (P < 0.001 for both variables). Early menarche was associated with early onset of ovulatory cycles. The times from menarche until 50% of the cycles were ovulatory were .apprx. 1, 3 and 4.5 yr when the ages at menarche were < 12.0, 12.0-12.9 and .gtoreq. 13.0 yr, respectively. Girls with a menarcheal age below 12.0 yr had higher serum estradiol but lower testosterone and dehydroepiandrosterone concentrations than subjects with later menarche. The estradiol to dehydroepiadrosterone ratio was already higher before menarche in subjects who displayed early menarche during follow-up. The increase in adrenal androgen secretion was mainly related to chronological age and was not affected by the time of menarche. The demonstration of early ovulation after early menarche is in conflict with the estrogen-window hypothesis suggesting a longer duration of anovulatory cycles to explain the increased risk of breast cancer after early menarche. Other theories should therefore be considered, among them the following: high serum progesterone concentration in association with normal or high serum estradiol at puberty increases the risk, only the early and relatively high estrogen concentrations are important, or the estrogen to androgen ratio is the critical factor, with androgens having a protective effect.