Zhang Ying, Howard Barbara V, Cowan Linda D, Welty Thomas K, Schaefer Carl F, Wild Robert A, Yeh Jeunliang, Lee Elisa T
Center for American Indian Health Research, University of Oklahoma HSC, Oklahoma City, Oklahoma 73190, USA.
J Womens Health (Larchmt). 2004 Mar;13(2):155-63. doi: 10.1089/154099904322966137.
To examine the associations of postmenopausal hormone therapy (PHT) with indicators of hemostasis and inflammation and with lipid profiles in American Indian women and to determine if diabetes modifies these associations.
This report is a cross-sectional analysis of data from 1446 postmenopausal women who were free from cardiovascular disease (CVD) at the second Strong Heart Study examination (1993-1995). Diabetes was diagnosed by WHO criteria. Postmenopausal hormone use was ascertained by review of the medications brought to the examination or by medical record review. Lipoproteins, plasminogen activator inhibitor type 1 (PAI-1), fibrinogen, and C-reactive protein (CRP) were measured in fasting plasma samples.
Among nondiabetic women, current PHT users had lower mean fibrinogen, PAI1, and low-density lipoprotein cholesterol (LDLC) levels than those in never users (38.4 mg/dl, 8.68 ng/ml, and 14.16 mg/dl lower, respectively) but higher CRP and triglyceride levels (1.53 mg/l and 31.43 mg/dl higher, respectively). Multivariate adjustment did not alter any of these associations. In diabetic women, current PHT use was associated only with lower PAI-1 (5.48 ng/ml lower) and higher high-density lipoprotein cholesterol (HDLC) levels (3.33 mg/dl higher) compared with never users.
In American Indian women without diabetes, PHT was associated with lower levels of hemostatic markers but higher levels of an inflammatory marker. Associations were less marked in women with diabetes. The relation of PHT with lipid profiles also differed in nondiabetic and diabetic women. These data provide an additional rationale for considering diabetes status when deciding whether or not to use PHT.
研究绝经后激素治疗（PHT）与美洲印第安女性止血和炎症指标以及血脂谱之间的关联，并确定糖尿病是否会改变这些关联。
本报告是对1446名绝经后女性的数据进行的横断面分析，这些女性在第二次强心脏研究检查（1993 - 1995年）时无心血管疾病（CVD）。糖尿病根据世界卫生组织标准诊断。通过审查带到检查现场的药物或病历回顾来确定绝经后激素的使用情况。在空腹血浆样本中测量脂蛋白、纤溶酶原激活物抑制剂1型（PAI - 1）、纤维蛋白原和C反应蛋白（CRP）。
在非糖尿病女性中，当前使用PHT的女性的平均纤维蛋白原、PAI1和低密度脂蛋白胆固醇（LDLC）水平低于从未使用者（分别低38.4mg/dl、8.68ng/ml和14.16mg/dl），但CRP和甘油三酯水平较高（分别高1.53mg/l和31.43mg/dl）。多变量调整并未改变这些关联中的任何一个。在糖尿病女性中，与从未使用者相比，当前使用PHT仅与较低的PAI - 1水平（低5.48ng/ml）和较高的高密度脂蛋白胆固醇（HDLC）水平（高3.33mg/dl）相关。
在没有糖尿病的美洲印第安女性中，PHT与较低的止血标志物水平相关，但与较高的炎症标志物水平相关。在糖尿病女性中这种关联不太明显。PHT与血脂谱的关系在非糖尿病和糖尿病女性中也有所不同。这些数据为在决定是否使用PHT时考虑糖尿病状态提供了额外的理论依据。
