Santoro Nanette, Lo Yungtai, Moskaleva Galina, Arnsten Julia H, Floris-Moore Michelle, Howard Andrea A, Adel Goli, Zeitlian Gohar, Schoenbaum Ellie E
Department of Obstetrics, Gynecology, and Women's Health, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA.
Menopause. 2007 Sep-Oct;14(5):859-65. doi: 10.1097/GME.0b013e31802f7369.
To determine whether reproductive hormone levels are affected by human immunodeficiency virus (HIV) and drug use.
HIV-infected and uninfected women (N=429), median age 45, were interviewed on menstrual frequency, demographic and psychosocial characteristics, and drug use behaviors. Serum was obtained on cycle days 1 to 5 in women reporting regular menses. Premenopausal-, early menopausal, and late menopausal transition and postmenopausal stages were assigned based on menstrual history. Serum was assayed for follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), prolactin, thyroid-stimulating hormone, and inhibin B. Body mass index, HIV serostatus, and CD4+ counts were measured. Factors associated with hormone concentrations were assessed using uni- and multivariable analyses. Hormone concentrations were compared within menstrual status categories using nonparametric comparisons of means.
In this cross-sectional analysis, LH and FSH increased, and E2 and inhibin B were significantly lower in women of older age and more advanced menopausal status. Increased body mass index was strongly associated with decreased LH. Opiate use was significantly associated with lower inhibin B and E2 and increased prolactin. Poorer self-rated health was statistically significantly associated with lower LH and FSH, but increased education was associated with higher LH and FSH. Among HIV-seropositive women, opiate users had detectably lower FSH and LH than nonusers, and use of highly active antiretroviral therapy was significantly related to higher LH, FSH, and E2, whereas cocaine use was associated with lower E2.
Age and menopausal status are strongly related to reproductive hormones. Body mass index and use of opiates, cocaine, and highly active antiretroviral therapy as well as educational attainment and perceived health can significantly modify reproductive hormones during the menopausal transition and need to be considered when interpreting hormone levels in middle-aged women.
确定生殖激素水平是否受人类免疫缺陷病毒（HIV）和药物使用的影响。
对429名年龄中位数为45岁的感染HIV和未感染HIV的女性进行访谈，内容包括月经频率、人口统计学和社会心理特征以及药物使用行为。在报告月经规律的女性的月经周期第1至5天采集血清。根据月经史划分绝经前、早期绝经、晚期绝经过渡和绝经后阶段。检测血清中的促卵泡生成素（FSH）、雌二醇（E2）、促黄体生成素（LH）、催乳素、促甲状腺激素和抑制素B。测量体重指数、HIV血清学状态和CD4+细胞计数。使用单变量和多变量分析评估与激素浓度相关的因素。使用均值的非参数比较在月经状态类别内比较激素浓度。
在这项横断面分析中，年龄较大和绝经状态更高级的女性中，LH和FSH升高，而E2和抑制素B显著降低。体重指数增加与LH降低密切相关。使用阿片类药物与抑制素B和E2降低以及催乳素升高显著相关。自我评定健康状况较差与LH和FSH降低在统计学上显著相关，但受教育程度提高与LH和FSH升高相关。在HIV血清阳性女性中，阿片类药物使用者的FSH和LH明显低于非使用者，使用高效抗逆转录病毒疗法与LH、FSH和E2升高显著相关，而使用可卡因与E2降低相关。
年龄和绝经状态与生殖激素密切相关。体重指数以及阿片类药物、可卡因和高效抗逆转录病毒疗法的使用，以及受教育程度和感知健康状况，在绝经过渡期间可显著改变生殖激素，在解释中年女性的激素水平时需要考虑这些因素。
