Wildman Rachel P, Colvin Alicia B, Powell Lynda H, Matthews Karen A, Everson-Rose Susan A, Hollenberg Steven, Johnston Janet M, Sutton-Tyrrell Kim
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Menopause. 2008 May-Jun;15(3):414-21. doi: 10.1097/gme.0b013e318154b6f5.
As associations between endogenous sex hormones and the vasculature are not well characterized, the objective was to examine the cross-sectional associations of menopausal status and endogenous sex hormones with vascular characteristics.
Common carotid artery adventitial diameter and intima-media thickness were determined using B-mode ultrasonography among 483 middle-aged women enrolled in the Pittsburgh and Chicago sites of the Study of Women's Health Across the Nation.
Sixty-two percent of women were pre- or early perimenopausal (<3 mo amenorrhea), 12% were late perimenopausal (3-12 mo amenorrhea), and 27% were postmenopausal (>or=12 mo amenorrhea). After adjustment for age, compared with pre-/early perimenopause, late perimenopause was associated with a 0.28-mm larger adventitial diameter (P=0.001), whereas postmenopause was associated with a 0.15-mm larger adventitial diameter (P=0.040). Adjustment for traditional cardiovascular risk factors slightly attenuated these associations, but the association with late perimenopause remained statistically significant (P=0.001). Each SD lower log estradiol value was associated with a 0.07-mm larger adventitial diameter after adjustment for traditional cardiovascular risk factors (P=0.023), whereas other endogenous hormones showed no associations. Intima-media thickness values were not significantly associated with menopausal status or endogenous sex hormones after adjustment for age.
The menopausal transition and declining estrogen levels are associated with alterations of the peripheral vasculature, which may help to explain the increased risk of cardiovascular disease with postmenopause.
由于内源性性激素与血管系统之间的关联尚未得到充分表征，本研究旨在探讨绝经状态和内源性性激素与血管特征的横断面关联。
在参加“全国女性健康研究”匹兹堡和芝加哥站点的483名中年女性中，采用B型超声测定颈总动脉外膜直径和内膜中层厚度。
62%的女性处于绝经前或围绝经期早期（闭经<3个月），12%处于围绝经期晚期（闭经3-12个月），27%处于绝经后（闭经≥12个月）。在调整年龄后，与绝经前/围绝经期早期相比，围绝经期晚期的外膜直径增大0.28mm（P=0.001），而绝经后的外膜直径增大0.15mm（P=0.040）。对传统心血管危险因素进行调整后，这些关联略有减弱，但围绝经期晚期与外膜直径的关联仍具有统计学意义（P=0.001）。在调整传统心血管危险因素后，每降低1个标准差的雌二醇对数水平与外膜直径增大0.07mm相关（P=0.023），而其他内源性激素则无关联。在调整年龄后，内膜中层厚度值与绝经状态或内源性性激素无显著关联。
绝经过渡和雌激素水平下降与外周血管系统的改变有关，这可能有助于解释绝经后心血管疾病风险增加的原因。
