Knopp R H
Northwest Lipid Research Centre, University of Washington, Seattle 98104.
Can J Cardiol. 1990 May;6 Suppl B:31B-35B.
Women are affected by disorders of lipid metabolism in the same way as men. Sex steroids given as oral contraceptives at all doses have clearcut, formulation-specific effects on lipoprotein levels in reproductive-aged women. In estrogen-dominant versus androgenic progestin-dominant formulations, LDL cholesterol levels were unchanged and significantly increased, respectively, and HDL cholesterol was increased and decreased, respectively. The greatest HDL lowering is seen with the most androgenic formulations. Major increases in LDL cholesterol confer risk for cardiovascular disease on this group, so caution is recommended in formulation selection. In general, cardiovascular disease risk in post menopausal women using estrogen is reduced 30 to 70%. Concurrent administration of progestin with post menopausal estrogen appears to reduce the beneficial rise in HDL associated with estrogen administration alone. Cardiovascular disease is likely to be reduced by estrogen in post menopausal women.
女性与男性一样会受到脂质代谢紊乱的影响。所有剂量的口服避孕药中的性类固醇对育龄女性的脂蛋白水平具有明确的、特定制剂的影响。在以雌激素为主与以雄激素占主导的孕激素为主的制剂中，低密度脂蛋白胆固醇水平分别保持不变和显著升高，而高密度脂蛋白胆固醇则分别升高和降低。雄激素作用最强的制剂使高密度脂蛋白降低得最多。低密度脂蛋白胆固醇的大幅升高使该群体面临心血管疾病风险，因此在选择制剂时建议谨慎。一般来说，绝经后使用雌激素的女性患心血管疾病的风险降低30%至70%。绝经后雌激素与孕激素同时使用似乎会降低单独使用雌激素时出现的高密度脂蛋白有益升高。绝经后女性使用雌激素可能会降低心血管疾病风险。
