内源性性激素作为老年男性和女性患痴呆症的风险因素。
Endogenous sex hormones as risk factors for dementia in elderly men and women.
作者信息
Ravaglia Giovanni, Forti Paola, Maioli Fabiola, Bastagli Luciana, Montesi Fausta, Pisacane Nicoletta, Chiappelli Martina, Licastro Federico, Patterson Christopher
机构信息
Department of Internal Medicine, Cardioangiology, and Hepatology, University Hospital S. Orsola, Malpighi, Via Massarenti, 9-40138 Bologna, Italy.
出版信息
J Gerontol A Biol Sci Med Sci. 2007 Sep;62(9):1035-41. doi: 10.1093/gerona/62.9.1035.
BACKGROUND
The associations of endogenous sex hormones with risk of dementia in the elderly population are not well known.
METHODS
The relationship of baseline serum total estradiol (E2) and free testosterone (FT) to 4-year risk of all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD) was examined in a dementia-free, population-based cohort of 433 women (mean age 74 years) and 376 men (mean age 73 years). Multivariable proportional hazards regression was used to adjust for sociodemographic and lifestyle variables, body mass index, apolipoprotein E genotype, cardiovascular conditions, and homocysteinemia.
RESULTS
Dementia developed in 71 women (46 AD, 21 VaD) and 39 men (23 AD, 12 VaD). In women with high E2 (serum E2 >or= 10 pg/mL), the multivariable-adjusted hazard ratio (HR) for dementia was 1.75 (95% confidence interval [CI], 1.06-2.89). The corresponding multivariable-adjusted HR for AD was 1.94 (95% CI, 1.04-3.61), whereas no association was found for VaD. No association with dementia was found for serum FT in women and for either serum E2 or FT in men.
CONCLUSION
High serum E2 is an independent predictor for dementia and AD in elderly women.
背景
内源性性激素与老年人群痴呆风险之间的关联尚不清楚。
方法
在一个无痴呆的基于人群的队列中，对433名女性（平均年龄74岁）和376名男性（平均年龄73岁）进行研究，检测基线血清总雌二醇（E2）和游离睾酮（FT）与全因痴呆、阿尔茨海默病（AD）和血管性痴呆（VaD）4年风险之间的关系。采用多变量比例风险回归分析来调整社会人口统计学和生活方式变量、体重指数、载脂蛋白E基因型、心血管疾病和高同型半胱氨酸血症。
结果
71名女性（46例AD，21例VaD）和39名男性（23例AD，12例VaD）发生痴呆。在E2水平高的女性（血清E2≥10 pg/mL）中，痴呆的多变量调整风险比（HR）为1.75（95%置信区间[CI]，1.06 - 2.89）。AD的相应多变量调整HR为1.94（95%CI，1.04 - 3.61），而未发现与VaD有关联。在女性中，血清FT与痴呆无关联；在男性中，血清E2和FT与痴呆均无关联。
结论
高血清E2是老年女性痴呆和AD的独立预测因素。
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