Santoro Nanette, Arnsten Julie H, Buono Donna, Howard Andrea A, Schoenbaum Ellie E
Department of Obstetrics, Gynecology and Women's Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461, USA.
J Womens Health (Larchmt). 2005 Dec;14(10):898-905. doi: 10.1089/jwh.2005.14.898.
To assess the impact of street drug use and HIV infection on reproductive hormones in 82 women aged 28?56 and 15 HIV-uninfected, regularly cycling premenopausal historical controls.
Prospective, pilot cohort study. Baseline blood samples were assayed for follicle stimulating hormone (FSH), human chorionic gonadotropin (hCG), prolactin (PRL), thyroid stimulating hormone (TSH), and estradiol (E(2)). Menopausal status was defined as premenopause: age<40, not amenorrheic; perimenopause: age>40, not amenorrheic; menopause: age>40, with> or =12 months' amenorrhea. Kruskal-Wallis testing was used to compare groups of women sorted by menopausal status and separated by drug use and HIV serostatus. Controls were regularly cycling premenopausal women.
Thirty-eight of the 82 women (46%) reported substance abuse, and 47 of the 82 (57%) were HIV infected. TSH did not differ by HIV serostatus or drug use. PRL was elevated in drug users compared with nonusers and healthy volunteers (10.3, 5.9 vs. 6.2 ng/ml, respectively, p = 0.002), with no effect of HIV serostatus. FSH was reduced in each menstrual category related to drug use and in postmenopausal women associated with positive HIV serostatus. Highly active antiretroviral therapy (HAART) use was not related to PRL or E(2) but was associated with higher FSH. FSH was greater in cohort participants compared with controls.
Drug use, not HIV, relates to increased PRL. Both drug use and HIV infection are associated with decreased FSH. Women in this socioeconomic stratum at high risk for HIV may be at risk for early menopause. Increased PRL may falsely reduce FSH, necessitating a more careful hormonal characterization of menopausal status in this sample of women.
评估街头毒品使用和HIV感染对82名年龄在28至56岁的女性以及15名未感染HIV、月经周期规律的绝经前历史对照者生殖激素的影响。
前瞻性试点队列研究。对基线血样进行卵泡刺激素（FSH）、人绒毛膜促性腺激素（hCG）、催乳素（PRL）、促甲状腺激素（TSH）和雌二醇（E₂）检测。绝经状态定义为：绝经前：年龄<40岁，无闭经；围绝经期：年龄>40岁，无闭经；绝经：年龄>40岁，闭经≥12个月。采用Kruskal-Wallis检验比较按绝经状态分类、按毒品使用和HIV血清学状态分组的女性群体。对照为月经周期规律的绝经前女性。
82名女性中有38名（46%）报告有药物滥用，82名中有47名（57%）感染了HIV。TSH在HIV血清学状态或毒品使用方面无差异。与非使用者和健康志愿者相比，吸毒者的PRL升高（分别为10.3、5.9和6.2 ng/ml，p = 0.002），HIV血清学状态无影响。与毒品使用相关的每个月经类别以及与HIV血清学阳性相关的绝经后女性中FSH降低。使用高效抗逆转录病毒疗法（HAART）与PRL或E₂无关，但与较高的FSH相关。队列参与者的FSH高于对照。
与HIV感染相比，毒品使用与PRL升高有关。毒品使用和HIV感染均与FSH降低有关。处于这种HIV高风险社会经济阶层的女性可能有过早绝经的风险。PRL升高可能会错误地降低FSH，因此需要对该女性样本的绝经状态进行更仔细的激素特征分析。
