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接受或未接受长期激素治疗的绝经后女性的血浆脂联素水平

Plasma adiponectin levels in postmenopausal women with or without long-term hormone therapy.

作者信息

Im Jee-Aee, Lee Ji-Won, Lee Hye-Ree, Lee Duk-Chul

机构信息

Department of Laboratory Medicine, MizMedi Hospital, and Department of Family Medicine, Yonsei University, College of Medicine, Seoul, Republic of Korea.

出版信息

Maturitas. 2006 Apr 20;54(1):65-71. doi: 10.1016/j.maturitas.2005.08.008. Epub 2005 Sep 29.

Abstract

OBJECTIVE

Recent large, prospective, randomized studies show that hormone therapy (HT) does not confer a protective effect against cardiovascular disease (CVD) but may in fact increase cardiovascular events. Low plasma adiponectin levels are considered to be related to the development of atherosclerosis and CVD. The purpose of this study was to determine the effect of long-term hormone therapy on plasma adiponectin levels in postmenopausal women.

METHODS

We recruited a total of 88 postmenopausal women aged 55-69 years old. Our sample consisted of 44 women who had undergone estrogen plus progestogen therapy (EPT) for more than 5 years and 44 age-matched women who had not received HT. We measured plasma adiponectin levels, the serum levels of their lipid profiles, high-sensitivity C-reactive protein (hs-CRP), fasting glucose levels, fasting insulin levels and estradiol levels. Their medical histories including their age at menopause, vitamin use, exercise, alcohol ingestion and cigarette smoking were also assessed by a questionnaire.

RESULTS

The mean duration (mean+/-S.D.) of HT was 8.4+/-2.4 years. The mean serum estradiol level (mean+/-S.D.) of the HT group was 47.9+/-36.8 pg/L, significantly higher than that of the non-HT group (p<0.01). Plasma adiponectin levels were significantly lower in the HT group than in the non-HT group (p<0.05). Plasma adiponectin levels were inversely correlated to cholesterol, triglycerides and HOMA-IR (r=-0.33, p<0.05; r=-0.40, p<0.01 and r=-0.30, p<0.05, respectively) in the non-HRT group, but such correlations were not seen in the HT group. In the multivariate analysis, hormone therapy and serum estradiol levels were the independent factors associated with plasma adiponectin levels after adjustments were made for potential confounders.

CONCLUSION

Plasma adiponectin levels were significantly lower in postmenopausal women with long-term HT than in those without HT, suggesting that long-term HT may modulate plasma adiponectin level in postmenopausal women.

摘要

目的

近期大规模、前瞻性、随机研究表明,激素疗法(HT)对心血管疾病(CVD)并无保护作用,实际上可能会增加心血管事件。血浆脂联素水平低被认为与动脉粥样硬化和CVD的发生有关。本研究的目的是确定长期激素疗法对绝经后女性血浆脂联素水平的影响。

方法

我们共招募了88名年龄在55 - 69岁的绝经后女性。我们的样本包括44名接受雌激素加孕激素疗法(EPT)超过5年的女性和44名年龄匹配但未接受HT的女性。我们测量了血浆脂联素水平、血脂谱的血清水平、高敏C反应蛋白(hs-CRP)、空腹血糖水平、空腹胰岛素水平和雌二醇水平。她们的病史,包括绝经年龄、维生素使用情况、运动、饮酒和吸烟情况,也通过问卷调查进行了评估。

结果

HT的平均持续时间(均值±标准差)为8.4±2.4年。HT组的平均血清雌二醇水平(均值±标准差)为47.9±36.8 pg/L,显著高于非HT组(p<0.01)。HT组的血浆脂联素水平显著低于非HT组(p<0.05)。在非激素替代疗法(HRT)组中,血浆脂联素水平与胆固醇、甘油三酯和HOMA-IR呈负相关(r分别为 -0.33,p<0.05;r为 -0.40,p<0.01;r为 -0.30,p<0.05),但在HT组中未观察到此类相关性。在多变量分析中,在对潜在混杂因素进行调整后,激素疗法和血清雌二醇水平是与血浆脂联素水平相关的独立因素。

结论

长期接受HT的绝经后女性的血浆脂联素水平显著低于未接受HT的女性,这表明长期HT可能会调节绝经后女性的血浆脂联素水平。

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