Endogenous/Exogenous Sex Hormones & CHD Risk Factors

内源性/外源性激素

• 批准号: 6478549
• 负责人: ELIZABETH L BARRETT-CONNOR
• 金额: $ 7.6万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6478549
• 关键词: blood chemistry; cardiovascular disorder risk; clinical research; estrogens; female; hormone therapy; human data; postmenopause; progesterone; sex hormones; steroid hormone metabolism; women's health

DESCRIPTION (provided by applicant): Coronary heart disease (CHD) is the most common cause of death in U.S. women. Observational studies consistently show that postmenopausal estrogen, with or without a progestin, reduces the risk of CHD, and there are several plausible mechanisms by which estrogen might protect the heart. Nevertheless, clinical trials to date have not demonstrated cardioprotection. If hormone levels play a role in determining CHD risk in postmenopausal women and HRT is to be used as a means of reducing that risk, the interactions of endogenous hormones, HRT, and CHD risk factors need further definition, in particular the effect of covariates. Individual characteristics such as basal hormone levels, body size, past hormone use, and lifestyle decisions may modify responses to HRT. This proposal focuses on four questions: 1) what factors determine circulating sex hormone levels in postmenopausal women, 2) what factors determine changes in sex hormone levels in response to hormone replacement therapy (HRT), 3) do endogenous sex hormone levels influence CHD risk factors in postmenopausal women, and 4) do changes in sex hormone levels with HRT predict the effect of HRT on CHD risk factors. These questions will be addressed by analyzing existing data from the Postmenopausal Estrogen / Progestin Interventions Trial (PEPI), a 3-year, multi-center, double-blind, placebo-controlled trial designed to compare the effect of estrogen alone and 3 estrogen/progestin HRT regimens vs placebo on selected CHD risk factors. There were 875 participants. Serum sex hormone levels, CHD risk factors, and potential covariates (including demographic characteristics, anthropometric measurements, reproductive history and lifestyle variables), determined at baseline and at 24 or 36 months of treatment, will be considered in the analyses. Results of this study will help define the differences between women with regard to endogenous sex hormone levels and responses to HRT, and the relation of sex hormones to CHD risk factors. These observations may aid in deciding whether individual women should use HRT and, if so, which regimen would provide the most benefit with the least risk.

描述（由申请人提供）： 冠心病（CHD）是美国女性最常见的死亡原因。 观察性研究一致表明，绝经后雌激素，与或 没有维生素A，降低了冠心病的风险，有几个合理的 雌激素保护心脏的机制然而，临床 迄今为止的试验尚未证明心脏保护作用。如果激素水平发挥作用 绝经后妇女和HRT在确定冠心病风险中的作用 作为降低这种风险的一种手段，内源性激素的相互作用， HRT和CHD危险因素需要进一步定义，特别是 协变量个体特征，如基础激素水平，身体 体型、过去激素使用和生活方式的决定可能会改变对HRT的反应。 本文主要探讨四个问题：1）什么因素决定流通 绝经后妇女的性激素水平，2）哪些因素决定变化 激素替代疗法（HRT）的性激素水平，3） 绝经后妇女内源性激素水平对冠心病危险因素的影响 女性，和4）做性激素水平的变化与HRT预测的影响， HRT对CHD危险因素的影响。这些问题将通过分析 绝经后雌激素/孕激素干预试验的现有数据 （PEPI），一项为期3年、多中心、双盲、安慰剂对照试验 旨在比较单独雌激素和3种雌激素/孕酮HRT的作用 方案与安慰剂对选定CHD风险因素的影响。有875人参加。 血清性激素水平、冠心病危险因素和潜在协变量 （包括人口统计特征、人体测量、 生殖史和生活方式变量），在基线和 24或36个月的治疗将在分析中考虑。结果 这项研究将有助于确定妇女之间的差异， 内源性激素水平和对HRT的反应以及性别的关系 激素对冠心病危险因素的影响。这些观察结果可能有助于决定是否 个别妇女应该使用HRT，如果是这样，哪种方案将提供 以最小的风险获得最大的收益。