2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, GR-11528, Athens, Greece.
Metabolism. 2012 Feb;61(2):193-201. doi: 10.1016/j.metabol.2011.06.005. Epub 2011 Aug 4.
Although increasing evidence supports an association between endogenous sex hormones and cardiovascular disease, the results still remain controversial. This study aims to examine the association between endogenous sex hormones and indices of vascular function and structure. Serum follicle-stimulating hormone, luteinizing hormone, estradiol, testosterone, sex hormone-binding globulin, dehydroepiandrosterone sulfate (DHEAS), and Δ4-androstenedione were measured in 120 healthy postmenopausal women aged 41 to 60 years. Possible associations with surrogate markers of subclinical atherosclerosis, arterial stiffness, and endothelial function were investigated. Indices of arterial structure included carotid and femoral intima-media thickness and atheromatous plaques presence. Indices of arterial function included flow-mediated dilation of the brachial artery, carotid-femoral pulse wave velocity (PWV), and augmentation index. Total testosterone and free androgen index (FAI) were the most important predictors of common carotid artery intima-media thickness (β = 0.376 and β = 0.236, P < .001 and P = .014, respectively). Similarly, FAI was the only significant independent predictor of PWV (β = 0.254, P = .027) after adjusting for age, smoking, body mass index, homeostasis model assessment of insulin resistance, and blood lipids. Free estrogen index showed a positive association with PWV, independently of age, smoking, and body mass index, but not of homeostasis model assessment of insulin resistance and blood lipids. Age-adjusted levels of DHEAS exhibited a significant independent negative association with measures of augmentation index. Follicle-stimulating hormone, luteinizing hormone, estradiol, sex hormone-binding globulin, and Δ4-androstenedione were not associated with any of the vascular parameters independently of traditional cardiovascular risk factors. Higher serum testosterone and FAI are associated with subclinical atherosclerosis in healthy recently menopausal women. This association is independent of traditional cardiovascular risk factors or insulin resistance. On the contrary, serum DHEAS exhibits a negative association with arterial stiffness.
虽然越来越多的证据支持内源性性激素与心血管疾病之间存在关联，但结果仍存在争议。本研究旨在探讨内源性性激素与血管功能和结构指标之间的关系。在 120 名年龄在 41 至 60 岁之间的健康绝经后女性中测量了血清卵泡刺激素、黄体生成素、雌二醇、睾酮、性激素结合球蛋白、硫酸脱氢表雄酮 (DHEAS) 和 Δ4-雄烯二酮。研究了它们与亚临床动脉粥样硬化、动脉僵硬和内皮功能的替代标志物的可能关联。动脉结构指数包括颈动脉和股动脉内膜中层厚度和粥样斑块的存在。动脉功能指数包括肱动脉血流介导的扩张、颈动脉-股动脉脉搏波速度 (PWV) 和增强指数。总睾酮和游离雄激素指数 (FAI) 是颈总动脉内膜中层厚度的最重要预测指标 (β=0.376 和 β=0.236，P<.001 和 P=.014)。同样，在调整年龄、吸烟、体重指数、胰岛素抵抗的稳态模型评估和血脂后，FAI 是 PWV 的唯一显著独立预测因子 (β=0.254，P=.027)。游离雌二醇指数与 PWV 呈正相关，独立于年龄、吸烟和体重指数，但与胰岛素抵抗的稳态模型评估和血脂无关。DHEAS 的年龄调整水平与增强指数的测量值呈显著独立的负相关。卵泡刺激素、黄体生成素、雌二醇、性激素结合球蛋白和 Δ4-雄烯二酮与任何血管参数均无关联，独立于传统心血管危险因素。较高的血清睾酮和 FAI 与健康绝经后近期女性的亚临床动脉粥样硬化有关。这种关联独立于传统心血管危险因素或胰岛素抵抗。相反，血清 DHEAS 与动脉僵硬呈负相关。
