激素与痴呆症——绝经后女性伴或不伴痴呆症的激素损伤比较研究。

Hormones and dementia - a comparative study of hormonal impairment in post-menopausal women, with and without dementia.

机构信息

Misericordia de Lisboa, Lisbon, Portugal.

出版信息

Neuropsychiatr Dis Treat. 2006 Jun;2(2):199-206. doi: 10.2147/nedt.2006.2.2.199.

DOI:10.2147/nedt.2006.2.2.199

PMID:19412464

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2671783/

Abstract

CONTEXT

Women seem to be more vulnerable to dementia, particularly Alzheimer's disease (AD), than men. There is controversy among studies correlating estrogen deficit to cognitive impairment. Because of the sudden drop of estrogens in menopause, this hormonal deficit could represent one of the risk factors for the larger incidence and prevalence of AD in post-menopausal women.

RATIONALE

We therefore wanted to find out if post-menopausal women with dementia, or even in a prior stage, mild cognitive impairment (MCI), would have a more significant deficit of estrogens than post-menopausal women without dementia, or any other type of cognitive problem.

OBJECTIVES

The aim of this study was to detect possible differences of the sex hormone levels among post-menopausal women, simultaneously affected by MCI or dementia, in comparison with a control group without cognitive impairment.

DESIGN, SETTING, AND PARTICIPANTS: A small, multicenter, prospective study was performed on 82 post-menopausal women (41 cases, 41 controls), aged 45-81 years, to investigate their sex hormone balance. The diagnosis of dementia was made according to ICD 9 or 10 and DSM III-R or IV appropriate to the time interval. The diagnosis of probable AD followed the NINCDS-ADRDA criteria. MCI met the Paquid-study criteria. Blood was analyzed in qualified centers for LH, FSH, and 17-beta-estradiol. All women went through a thorough psychiatric examination and those with a suspected hormonal impairment were examined by a gynecologist.

RESULTS

15 cases (36.6%) had impaired hormonal function, compared with 8 controls (19.5%). Of the 15 cases with hormonal impairment, 9 had MCI.

CONCLUSIONS

These preliminary data stress a considerable difference between the sex hormone status of these two populations, showing a tendency towards a more accentuated estrogen deficit linked to cognitive deficit. Enlarging the sample and following the evolution could bring more interesting data.

摘要

背景

女性似乎比男性更容易患上痴呆症，尤其是阿尔茨海默病（AD）。研究表明雌激素缺乏与认知障碍有关，但这种说法存在争议。由于绝经后雌激素水平突然下降，这种激素缺乏可能是绝经后女性 AD 发病率和患病率较高的原因之一。

理据

因此，我们想了解是否患有痴呆症的绝经后妇女，甚至是轻度认知障碍（MCI）前期的妇女，其雌激素缺乏程度是否比没有痴呆症或任何其他类型认知问题的绝经后妇女更严重。

目的

本研究旨在检测同时患有 MCI 或痴呆症的绝经后妇女的性激素水平是否存在差异，并与无认知障碍的对照组进行比较。

设计、地点和参与者：这是一项小型、多中心、前瞻性研究，共纳入 82 名年龄在 45-81 岁之间的绝经后妇女（41 例病例，41 例对照），以调查她们的性激素平衡状况。痴呆症的诊断依据 ICD 9 或 10 以及 DSM III-R 或 IV 标准，适用于不同的时间间隔。AD 的诊断符合 NINCDS-ADRDA 标准。MCI 符合 Paquid 研究标准。在合格的中心对 LH、FSH 和 17-β-雌二醇进行了分析。所有妇女都接受了全面的精神科检查，那些疑似激素功能障碍的妇女由妇科医生进行检查。