Inserm and University Paris XI, CESP Centre for Research in Epidemiology and Population Health, UMR-S 1018, Team 08: "Hormones and Cardiovascular Disease, Villejuif, France.
Menopause. 2011 Aug;18(8):873-9. doi: 10.1097/gme.0b013e31820eee88.
Increased thrombin generation has emerged as a new surrogate marker of venous thromboembolism. Using calibrated automated thrombography, we tested the influence of the route of estrogen administration and progestogens on thrombin generation among postmenopausal women using hormone therapy.
Baseline thrombin generation, together with clotting factors and inhibitors, was determined in plasma from 115 healthy postmenopausal women. Women were classified by the use of hormone therapy into three groups: nonusers (n = 38), users of oral estrogens (n = 38), and users of transdermal estrogens (n = 39).
Oral estrogens dose dependently increased thrombin generation. Thrombin generation was increased among users of transdermal estrogens combined with progestins but was similar to nonusers among women using transdermal estrogens plus progesterone. Prothrombin was the main determinant of thrombin generation and explained a part of these differences. However, single clotting factors and inhibitors contributed little to the hormone-related changes in thrombin generation.
Increased thrombin generation can be detected in women using hormone therapy, but this hypercoagulable phenotype depends both on the route of estrogen administration and the type of progestogens. These findings are consistent with current data on the risk of venous thromboembolism related to hormone therapy.
凝血酶生成增加已成为静脉血栓栓塞症的新替代标志物。我们使用校准的自动化血栓描记术，检测了激素治疗中雌激素给药途径和孕激素对绝经后妇女凝血酶生成的影响。
从 115 名健康绝经后妇女的血浆中测定了基线凝血酶生成以及凝血因子和抑制剂。根据激素治疗的使用情况，将妇女分为三组：非使用者（n = 38）、口服雌激素使用者（n = 38）和经皮雌激素使用者（n = 39）。
口服雌激素剂量依赖性地增加了凝血酶生成。与非使用者相比，使用经皮雌激素联合孕激素的妇女凝血酶生成增加，但使用经皮雌激素加孕激素的妇女凝血酶生成与非使用者相似。凝血酶原是凝血酶生成的主要决定因素，解释了这些差异的一部分。然而，单个凝血因子和抑制剂对凝血酶生成与激素相关的变化贡献不大。
使用激素治疗的妇女可检测到凝血酶生成增加，但这种高凝表型既取决于雌激素的给药途径，也取决于孕激素的类型。这些发现与激素治疗与静脉血栓栓塞风险的现有数据一致。
