皮质醇水平升高：绝经期症状与心血管危险因素之间的可能联系。

Increased cortisol level: a possible link between climacteric symptoms and cardiovascular risk factors.

机构信息

Department Obstetrics Gynecology and Pediatrics, Obstetrics and Gynecology Unit, Azienda Ospedaliero-Universitaria of Modena, Modena, Italy.

出版信息

Menopause. 2011 Mar;18(3):273-8. doi: 10.1097/gme.0b013e3181f31947.

DOI:10.1097/gme.0b013e3181f31947

PMID:21037488

Abstract

OBJECTIVE

Vasomotor symptoms may increase the risk for cardiovascular diseases through still elusive mechanisms. Increased cortisol release may favor atherosclerosis. In this study, we tested whether vasomotor and psychological symptoms are associated with an increase in cortisol levels.

METHODS

A cross-sectional investigation on women in early menopause enrolled consecutively between January and June 2009 was conducted. This study was set at a menopause outpatient service at University Hospital. Participants included 85 healthy women who were 6 months to 5 years postmenopause. The 24-hour urinary cortisol level and Greene Climacteric Scale scores were evaluated. Anthropometric parameters and fasting blood samples for the determination of high-density lipoprotein (HDL) cholesterol, total cholesterol, triglycerides, glucose, and insulin levels were measured. Body mass index, waist-to-hip ratio, and homeostatic model assessment of insulin resistance were calculated. The relation between Greene Climacteric Scale scores and 24-hour urinary cortisol level and between 24-hour urinary cortisol level and lipid levels or insulin resistance was determined.

RESULTS

The Greene Climacteric Scale score for climacteric symptoms (coefficient of regression [CR], 1.343; 95% CI, 0.441-2.246) and body mass index (CR, 4.469; 95% CI, 1.259-7.678) explained 32.5% and 10.3%, respectively, of the variance in 24-hour urinary cortisol level (r = 0.428; P = 0.0003). Twenty-four-hour urinary cortisol level was inversely related to HDL-cholesterol level (CR, -0.065; 95% CI, -0.114 to -0.017; r = 0.283; P = 0.009) and was related to waist girth (CR, 0.685; 95% CI, 0.306-1.063) and homeostatic model assessment of insulin resistance (CR, 0.097; 95% CI, 0.032-0.162; r = 0.510; P = 0.0001).

CONCLUSIONS

In early postmenopausal women, the Greene Climacteric Scale score is associated with increased 24-hour urinary cortisol level. Increased cortisol level is associated with known risk factors for cardiovascular disease, such as insulin resistance and decreased HDL-cholesterol level.

摘要

目的

血管舒缩症状可能通过仍未被揭示的机制增加心血管疾病的风险。皮质醇释放增加可能有利于动脉粥样硬化。在这项研究中，我们测试了血管舒缩和心理症状是否与皮质醇水平的升高有关。

方法

2009 年 1 月至 6 月连续纳入处于早期绝经后的女性进行横断面研究。本研究在大学医院的绝经期门诊服务处进行。参与者包括 85 名绝经后 6 个月至 5 年的健康女性。评估 24 小时尿皮质醇水平和格林绝经量表评分。测量人体测量参数和空腹血样，以测定高密度脂蛋白（HDL）胆固醇、总胆固醇、甘油三酯、血糖和胰岛素水平。计算体重指数、腰臀比和胰岛素抵抗的稳态模型评估。确定格林绝经量表评分与 24 小时尿皮质醇水平之间的关系，以及 24 小时尿皮质醇水平与血脂水平或胰岛素抵抗之间的关系。

结果

绝经期症状的格林绝经量表评分（回归系数[CR]，1.343；95%置信区间，0.441-2.246）和体重指数（CR，4.469；95%置信区间，1.259-7.678）分别解释了 24 小时尿皮质醇水平（r = 0.428；P = 0.0003）的 32.5%和 10.3%。24 小时尿皮质醇水平与高密度脂蛋白胆固醇水平呈负相关（CR，-0.065；95%置信区间，-0.114 至-0.017；r = 0.283；P = 0.009），与腰围（CR，0.685；95%置信区间，0.306-1.063）和胰岛素抵抗的稳态模型评估（CR，0.097；95%置信区间，0.032-0.162；r = 0.510；P = 0.0001）相关。