SEX STEROID HORMONES AND RISK OF CHD IN WOMEN

描述：（改编自研究者摘要）生物学研究 描述了雌激素对心血管系统的不同影响， 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，直接数据显示， 内源性激素水平能否预测冠心病的风险 疾病（CHD）是稀疏和不确定的。此应用程序将评估 内源性雌、雄激素水平与冠心病危险性的关系 在妇女健康倡议观察性研究中，a 对93，726名年龄在50 - 79岁的绝经后妇女进行的前瞻性队列研究， 研究入口。使用嵌套病例对照设计，研究人员将测量 基线性类固醇激素水平（血清总和游离雌二醇、雌酮 硫酸睾酮、总睾酮和游离睾酮、硫酸脱氢表雄酮）与性别 激素结合球蛋白，以确定这些是否预测随后的风险， 冠心病病例和对照受试者将从没有 研究入组时患有心血管疾病和癌症，未使用激素 基线时的替代治疗。案件将是那些妇女， 发生记录的心肌梗死或接受冠状动脉 血运重建（N = 350），而对照受试者将从研究中选择 随访期间未发生CHD的受试者。控件将被 年龄、种族、吸烟和随访时间1：1匹配。他们还将 检查性类固醇激素水平和其他先前的 生物标志物的资助分析，包括血栓形成和炎症标志物， 脂蛋白、空腹血糖和胰岛素。详细的基线数据，包括 人体测量学和行为因素将使他们能够控制 混淆以及评价效果改变。本研究以 WHI-OS的独特属性的优势，大规模的种族 正在进行高质量随访的绝经后妇女的多样化队列 终点验证，并存档血液标本，使拟议的研究 非常高效。研究人员指出，由于CHD是导致 绝经后妇女的死亡，检查内源性激素在绝经后妇女中的作用， 绝经后妇女是一个重要的和有前途的研究领域。

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.