HRT, HPA AXIS REACTIVITY AND MEMORY FUNCTION

绝经后妇女的激素替代疗法（HRT）是相当大的研究兴趣的焦点，因为它的好处可能包括降低冠心病和骨质疏松症的风险，以及防止认知功能下降，特别是记忆能力。我们建议获得初步的数据来测试的假设，负责HRT的有益的记忆效果的基本机制之一是衰减下丘脑-垂体-肾上腺（HPA）轴的反应性。该研究将通过比较三组女性来测试HRT相关的皮质醇反应性衰减，以对抗挑战和记忆障碍的保护：30名服用雌激素/雌激素方案[EP]，30名仅服用雌激素[E-only]，30名未使用HRT [no-HRT]。妇女将参加一个标准化的社会认知挑战（必须给一个小组的评估），管理在加州大学洛杉矶分校临床研究中心;唾液的模式“自由”皮质醇的反应，以测试的挑战，HRT是与减弱HPA轴反应性的假设进行评估。将在挑战前和挑战后评估记忆表现，以检验使用HRT的女性由于在挑战期间皮质醇升高较小而表现出较小下降的假设。本研究的结果将被用作HRT临床试验的R 0 I应用的初步数据，旨在进一步阐明HRT对HPA轴影响的基本机制，包括ACTH和CRH调节，并在实验设计中证明HRT对皮质醇调节的影响及其对记忆性能的影响。

Hormone replacement therapy (HRT) in postmenopausal women is the focus of considerable research interest because its benefits may include reductions in risk for coronary heart disease and osteoporosis, as well as protection against declines in cognitive functioning, particularly memory performance. We propose to obtain preliminary data to test the hypothesis that one of the basic mechanisms responsible for the beneficial memory effects of HRT is an attenuation of hypothalamic-pituitary-adrenal (HPA) axis reactivity. The study will test for HRT-associated attenuation of cortisol reactivity to challenge and protection against memory impairment by comparing three groups of women: 30 taking an estrogen/progestin regimen [EP], 30 taking estrogen-only [E-only], and 30 not using HRT [no-HRT]. The women will participate in a standardized social-cognitive challenge (having to give a talk to a panel of evaluators), administered at the UCLA Clinical Research Center; patterns of salivary "free" cortisol reactivity to the challenge will be assessed to test the hypothesis that HRT is associated with attenuated HPA axis reactivity. Memory performance will be assessed pre and post-challenge to test the hypothesis that women using HRT will show smaller declines as a consequence of their smaller cortisol elevations during the challenge. Results from this study will be used as preliminary data for an R0I application for an HRT clinical trial designed to further elucidate the basic mechanisms of HRT effects on the HPA axis, including ACTH and CRH regulation, and to demonstrate, in an experimental design, HRT effects on cortisol regulation and the impact of this on memory performance.