Sanada Mitsuhiro, Higashi Yukihito, Nakagawa Keigo, Kodama Ichiro, Tsuda Mikio, Nagai Nobutaka, Chayama Kazuaki, Ohama Koso
Department of Obstetrics and Gynecology, Faculty of Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Maturitas. 2003 Apr 25;44(4):307-15. doi: 10.1016/s0378-5122(03)00045-8.
We sought to determine whether menopausal status or postmenopausal hypercholesterolemia affects forearm resistance artery endothelial function. We studied the forearm resistance artery endothelial function in 75 Japanese women: 25 premenopausal volunteers, 25 postmenopausal women with normal serum low-density lipoprotein (LDL) cholesterol concentrations, and 25 hypercholesterolemic postmenopausal women. Excluded from the study were patients with hypertriglyceridemia, hypertension, or diabetes, cigarette smokers. The forearm blood flow (FBF) during reactive hyperemia and after sublingual nitroglycerin (NTG) administration was measured by strain-gauge plethysmography. The serum concentrations of lipoprotein (a) [Lp(a)] were significantly higher in the hypercholesterolemic postmenopausal group than in the other two groups (P<0.01). These lipid parameters were similar between the premenopausal and postmenopausal women with normal cholesterol. The FBF responses to reactive hyperemia were significantly lower in the postmenopausal hypercholesterolemic women than in the other two groups (P<0.01). The reactive hyperemia also was impaired in the postmenopausal group with normal cholesterol as compared with the premenopausal group (P<0.01). Increases in FBF after NTG were similar between the three groups. By stepwise multivariate analysis, menopausal status and serum LDL cholesterol was the significant predictor of forearm endothelial function. These findings suggest that reactive hyperemia is impaired in forearm resistance arteries after menopause, especially in postmenopausal women with hypercholesterolemia.
我们试图确定绝经状态或绝经后高胆固醇血症是否会影响前臂阻力动脉的内皮功能。我们研究了75名日本女性的前臂阻力动脉内皮功能：25名绝经前志愿者、25名血清低密度脂蛋白（LDL）胆固醇浓度正常的绝经后女性和25名高胆固醇血症绝经后女性。排除患有高甘油三酯血症、高血压或糖尿病的患者以及吸烟者。通过应变片体积描记法测量反应性充血期间和舌下含服硝酸甘油（NTG）后的前臂血流量（FBF）。高胆固醇血症绝经后组的脂蛋白（a）[Lp（a）]血清浓度显著高于其他两组（P<0.01）。绝经前和胆固醇正常的绝经后女性之间的这些血脂参数相似。绝经后高胆固醇血症女性对反应性充血的FBF反应显著低于其他两组（P<0.01）。与绝经前组相比，胆固醇正常的绝经后组的反应性充血也受损（P<0.01）。三组之间NTG后FBF的增加相似。通过逐步多变量分析，绝经状态和血清LDL胆固醇是前臂内皮功能的重要预测指标。这些发现表明，绝经后前臂阻力动脉的反应性充血受损，尤其是在高胆固醇血症的绝经后女性中。
