Chan Mei-Fen, Dowsett Mitch, Folkerd Elizabeth, Wareham Nicholas, Luben Robert, Welch Ailsa, Bingham Sheila, Khaw Kay-Tee
Department of Public Health and Primary Care, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom.
Menopause. 2008 Mar-Apr;15(2):332-9. doi: 10.1097/gme.0b013e31806458d9.
Exogenous sex hormone use is associated with many health effects. Current exogenous hormone use influences endogenous sex hormone levels, but little is known about longer term effects on endogenous hormones after cessation of use. The aim of this study was to examine the relationship between past hormone use and current endogenous hormone status.
This was a cross-sectional study of 1,983 postmenopausal women aged 55 to 81 years from the general community. The women were not currently using exogenous hormones. Past use of oral contraceptives (OCs) and hormone therapy (HT) as well as circulating endogenous sex hormones and sex hormone-binding globulin concentrations were evaluated.
Past OC users had significantly lower endogenous estradiol, estrone, androstenedione, testosterone, and sex hormone-binding globulin concentrations compared with never users independent of age, body mass index, smoking, physical activity, and reproductive factors. Past HT users had significantly lower testosterone and 17alpha-hydroxyprogesterone concentrations. Past OC use and HT use were both independently associated with lower testosterone concentrations: -9% (95% CI: -16% to -2%) for ever OC use compared with never OC use and -7% (95% CI: -17% to -2%) for ever HT use compared with never HT use. The magnitude of 5% to 10% differences in endogenous hormone concentrations was similar or greater for past OC use compared with past HT use, although OC use occurred earlier in the past.
Past OC use and HT use seem to be related to long-term differences in endogenous sex hormones and sex hormone-binding globulin concentrations in postmenopausal women many years after cessation of use. These findings have implications for understanding the longer term effects of exogenous hormone exposures earlier in life with health and disease risk in later life.
外源性性激素的使用与多种健康影响相关。当前外源性激素的使用会影响内源性性激素水平,但对于停用后对内源性激素的长期影响知之甚少。本研究的目的是探讨既往激素使用与当前内源性激素状态之间的关系。
这是一项对来自普通社区的1983名年龄在55至81岁之间的绝经后女性进行的横断面研究。这些女性目前未使用外源性激素。评估了既往口服避孕药(OCs)和激素疗法(HT)的使用情况以及循环内源性性激素和性激素结合球蛋白的浓度。
与从未使用者相比,既往使用OCs的使用者,其独立于年龄、体重指数、吸烟、身体活动和生殖因素的内源性雌二醇、雌酮、雄烯二酮、睾酮和性激素结合球蛋白浓度显著降低。既往使用HT的使用者,其睾酮和17α-羟孕酮浓度显著降低。既往使用OCs和HT均与较低的睾酮浓度独立相关:与从未使用OCs相比,既往使用OCs者的睾酮浓度降低9%(95%置信区间:-16%至-2%);与从未使用HT相比,既往使用HT者的睾酮浓度降低7%(95%置信区间:-17%至-2%)。尽管OCs的使用时间更早,但既往使用OCs导致的内源性激素浓度差异幅度为5%至10%,与既往使用HT相似或更大。
既往使用OCs和HT似乎与绝经后女性停用多年后的内源性性激素和性激素结合球蛋白浓度的长期差异有关。这些发现对于理解生命早期外源性激素暴露对晚年健康和疾病风险的长期影响具有重要意义。