Department of Woman and Child Health, Division of Obstetrics and Gynecology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Gynecol Endocrinol. 2009 Dec;25(12):823-7. doi: 10.3109/09513590903056134.
To analyze the effects of testosterone addition to estrogen therapy in comparison with estrogen alone on cardiovascular risk factors in postmenopausal women.
Fifty surgically postmenopausal women were included in this double-blind, placebo-controlled and randomized study to receive daily oral treatment with estradiol valerate 2 mg + placebo (E/P) or estradiol valerate 2 mg + testosterone undecanoate 40 mg (E/T) for 24 weeks and then switched to the other regimen for another 24 weeks. Sex hormones, High sensitivity CRP (hsCRP), Interleukin-6 (IL-6), Tissue necrosis factor (TNF)-alpha, Insulin-like growth factor binding globulin (IGFBP-1), vascular cell adhesion molecule (VCAM)- 1, and homocysteine were analyzed at baseline and after 6 and 12 months.
Estradiol and androgens increased as expected during the treatments. After 6 months of E/P, increases of hsCRP and IGFBP-1 and a decline of VCAM were recorded, whereas IL-6, TNF-alpha, and homocysteine were unchanged. When testosterone was added to estrogen, the increase of IGFBP-1 and decline in VCAM was similar as with estrogen treatment alone. However, testosterone addition counteracted the estrogen-induced rise in hsCRP but had no effects on IL-6, TNF-alpha, and homocysteine.
Data suggest that testosterone addition to estrogen treatment in postmenopausal women has a modest influence on inflammatory markers and there were no apparent adverse effects. On the contrary, the estrogen-induced increase in hsCRP was suppressed.
分析与单独使用雌激素相比，雄激素联合雌激素治疗对绝经后妇女心血管危险因素的影响。
本研究采用双盲、安慰剂对照和随机方法，纳入 50 例接受手术绝经的女性，每天口服戊酸雌二醇 2mg+安慰剂（E/P）或戊酸雌二醇 2mg+十一酸睾酮 40mg（E/T），共 24 周，然后再转换为另一种方案治疗 24 周。在基线、6 个月和 12 个月时分析性激素、高敏 C 反应蛋白（hsCRP）、白细胞介素 6（IL-6）、肿瘤坏死因子-α（TNF-α）、胰岛素样生长因子结合球蛋白（IGFBP-1）、血管细胞黏附分子（VCAM）-1 和同型半胱氨酸。
治疗期间，雌、雄激素水平如预期增加。E/P 治疗 6 个月后，hsCRP 和 IGFBP-1 增加，VCAM 降低，而 IL-6、TNF-α和同型半胱氨酸不变。当雄激素与雌激素联合应用时，IGFBP-1 的增加和 VCAM 的下降与单独用雌激素治疗相似。然而，雄激素可拮抗雌激素诱导的 hsCRP 升高，但对 IL-6、TNF-α和同型半胱氨酸无影响。
数据表明，雄激素联合雌激素治疗绝经后妇女对炎症标志物有一定影响，且无明显不良反应。相反，雌激素诱导的 hsCRP 升高被抑制。
