卵巢切除术、绝经、雌激素与认知衰老：时间假说。
Oophorectomy, menopause, estrogen, and cognitive aging: the timing hypothesis.
机构信息
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
出版信息
Neurodegener Dis. 2010;7(1-3):163-6. doi: 10.1159/000289229. Epub 2010 Mar 3.
BACKGROUND
The concept of neuroprotective effects of estrogen in women remains controversial.
OBJECTIVE
To explore the timing hypothesis in relation to cognitive aging and dementia.
METHODS
We reviewed existing literature, conducted some reanalyses, and combined results graphically.
RESULTS
Current evidence suggests that estrogen may have either protective effects or harmful effects on the brain depending on age, type of menopause (natural versus surgical), or stage of menopause. The comparison of women with ovarian conservation versus women who underwent bilateral oophorectomy provided evidence for a sizeable neuroprotective effect of estrogen in women in the premenopausal years (most commonly before age 50 years). Several case-control studies and cohort studies also showed a neuroprotective effect in women who received estrogen treatment in the early postmenopausal phase (most commonly at ages 50-60 years). However, recent clinical trials showed that women who initiated estrogen treatment in the late postmenopausal phase (ages 65-79 years) experienced an increased risk of dementia and cognitive decline.
CONCLUSION
The neuroprotective effects of estrogen depend on age, type of menopause, and stage of menopause (timing hypothesis).
背景
雌激素对女性的神经保护作用的概念仍然存在争议。
目的
探讨与认知衰老和痴呆相关的时间假说。
方法
我们回顾了现有文献，进行了一些重新分析，并以图形方式结合了结果。
结果
目前的证据表明，雌激素对大脑可能具有保护作用，也可能具有有害作用，这取决于年龄、绝经类型（自然绝经与手术绝经）或绝经阶段。比较卵巢保留的女性与接受双侧卵巢切除术的女性，为绝经前（通常在 50 岁之前）女性的雌激素具有相当大的神经保护作用提供了证据。几项病例对照研究和队列研究也表明，在绝经早期（通常在 50-60 岁）接受雌激素治疗的女性具有神经保护作用。然而，最近的临床试验表明，在绝经后期（65-79 岁）开始接受雌激素治疗的女性患痴呆症和认知能力下降的风险增加。
结论
雌激素的神经保护作用取决于年龄、绝经类型和绝经阶段（时间假说）。
Zotero 插件