SEX STEROID HORMONES AND RISK OF CHD IN WOMEN

描述：(改编自《调查者摘要》)生物学研究 描述雌激素对心血管系统的各种影响，以及 观察性研究表明，外源性激素可能会减少 绝经后妇女的心血管风险。然而，关于以下方面的直接数据 内源性激素水平是否可预测随后的冠心病风险 疾病(CHD)是稀疏和不确定的。此应用程序将评估 内源性雌激素和雄激素水平与冠心病风险的关系 在妇女健康倡议-观察性研究(WHI-OS)的妇女中， 对93,726名50-79岁绝经后妇女的前瞻性队列研究 学习条目。使用嵌套病例对照设计，调查人员将测量 基线性类固醇激素水平(血清总雌二醇和游离雌二醇、雌酮 硫酸盐、总睾酮和游离睾酮、脱氢表雄酮硫酸盐)和性别 激素结合球蛋白，以确定它们是否预测随后的风险 先心病。病例和对照受试者将从 心血管疾病和癌症在研究开始时没有使用激素 基线时的替代疗法。病例将是那些后来 患上有记载的心肌梗死或接受过冠状动脉 血管重建术(N=350)，而对照对象将从研究中选择 在随访期间仍未患冠心病的参与者。控制将是 在年龄、种族、吸烟和随访时间方面1：1匹配。他们还将 检验性类固醇激素水平与以往其他疾病的相关性 资助生物标记物的分析，包括血栓和炎症标记物， 脂蛋白、空腹血糖和胰岛素。详细的基线数据包括 人体测量和行为因素将使他们能够控制 混杂以及评价效果修改。这项研究采取了 利用WHI-OS的独特属性，在种族上大规模 不同的绝经后妇女队列，持续跟踪，高质量 终点验证，以及存档的血液样本，进行拟议的研究 非常高效。调查人员表示，由于CHD是导致 绝经后妇女的死亡，检查内源性激素对妇女的影响 绝经后妇女是一个重要而有前途的研究领域。

DESCRIPTION: (Adapted from the Investigator's Abstract) Biologic studies describe diverse effects of estrogen on the cardiovascular system and observational studies indicate that exogenous hormones may decrease cardiovascular risk in postmenopausal women. However, direct data regarding whether endogenous hormone levels predict subsequent risk of coronary heart disease (CHD) are sparse and inconclusive. This application will evaluate the relationship between endogenous estrogen and androgen levels and risk of CHD among women in the Women's Health Initiative-Observational Study (WHI-OS), a prospective cohort study of 93,726 postmenopausal women age 50-79 years at study entry. Using a nested-case control design, the investigators will measure baseline sex steroid hormone levels (serum total and free estradiol, estrone sulfate, total and free testosterone, dehydroepiandrosterone sulfate) and sex hormone binding globulin to determine whether these predict subsequent risk of CHD. Case and control subjects will be selected from women who were free from cardiovascular disease and cancer at study entry and were not using hormone replacement therapy at baseline. Cases will be those women who subsequently developed a documented myocardial infarction or underwent coronary artery revascularization (N=350), while control subjects will be selected from study participants who remained free from CHD during follow-up. Controls will be matched 1:1 for age, ethnicity, smoking and follow-up time. They will also examine correlations between sex steroid hormone levels and other previously funded analyses of biomarkers, including thrombotic and inflammatory markers, lipoproteins, fasting glucose and insulin. Detailed baseline data including anthropometrics and behavioral factors will allow them to control for confounding as well as to evaluate effect modification. This study takes advantage of the unique attributes of the WHI-OS, a large scale ethnically diverse cohort of postmenopausal women with ongoing follow-up, high quality endpoint verification, and archived blood specimens, making the proposed study very efficient. The investigators state that since CHD is the leading cause of death in postmenopausal women, examining the effects of endogenous hormones in postmenopausal women is an important and promising area of inquiry.