超重和肥胖的绝经后非裔美国女性及非非裔美国女性在体重减轻和维持期间的性激素变化。
Sex hormone changes during weight loss and maintenance in overweight and obese postmenopausal African-American and non-African-American women.
作者信息
Stolzenberg-Solomon Rachael Z, Falk Roni T, Stanczyk Frank, Hoover Robert N, Appel Lawrence J, Ard Jamy D, Batch Bryan C, Coughlin Janelle, Han Xu, Lien Lillian F, Pinkston Christina M, Svetkey Laura P, Katki Hormuzd A
出版信息
Breast Cancer Res. 2012 Oct 31;14(5):R141. doi: 10.1186/bcr3346.
INTRODUCTION
Changes in sex hormones with weight loss might have implications for breast cancer prevention but have not been examined extensively, particularly in African-American (AA) women.
METHODS
We conducted a prospective study of 278 overweight/obese postmenopausal women (38% AA) not taking hormone therapy within the Weight Loss Maintenance Trial. All participants lost at least 4 kg after a 6-month weight-loss phase and attempted to maintain weight loss during the subsequent 12 months. We evaluated the percentage changes in estrone, estradiol, free estradiol, testosterone, free testosterone, androstenedione, dehydroepiandrosterone sulfate and sex hormone-binding globulin (SHBG) using generalized estimating equations.
RESULTS
In all study phases, AA women had higher levels of estrogen and testosterone concentrations, independent of adiposity. On average, participants lost 7.7 kg during the weight-loss phase, and concentrations of estrone (-5.7%, P = 0.006), estradiol (-9.9%, P <0.001), free estradiol (-13.4%, P <0.0001), and free testosterone (-9.9%, P <0.0001) decreased, while the SHBG concentration (16.2%, P <0.001) increased. Weight change did not significantly affect total testosterone or other androgen concentrations. Compared with non-AA women, AA women experienced less change in estrogens per kilogram of weight change (that is, per 1 kg weight loss: estrone, -0.6% vs. -1.2%, P-interaction = 0.10; estradiol, -1.1% vs. -1.9%, P-interaction = 0.04; SHBG, 0.9% vs. 1.6%, P-interaction = 0.006; free estradiol, -1.4% vs. -2.1%, P-interaction = 0.01).
CONCLUSION
To the best of our knowledge this is the first study to examine and compare the effects of intentional weight loss and maintenance on a panel of sex hormones in AA women and non-AA women. Although speculative, these data suggest hormonal differences may contribute to different racial patterns of breast cancer incidence and mortality and encourage further investigations to understand the long-term effects of weight loss on sex hormones in obese postmenopausal women.
TRIAL REGISTRATION
ClinicalTrials.gov: NCT00054925.
引言
体重减轻伴随的性激素变化可能对乳腺癌预防有影响，但尚未得到广泛研究，尤其是在非裔美国（AA）女性中。
方法
我们在体重减轻维持试验中对278名未接受激素治疗的超重/肥胖绝经后女性（38%为AA女性）进行了一项前瞻性研究。所有参与者在6个月的体重减轻阶段后至少减重4千克，并在随后的12个月内尝试维持体重减轻。我们使用广义估计方程评估雌酮、雌二醇、游离雌二醇、睾酮、游离睾酮、雄烯二酮、硫酸脱氢表雄酮和性激素结合球蛋白（SHBG）的百分比变化。
结果
在所有研究阶段，AA女性的雌激素和睾酮浓度较高，与肥胖程度无关。平均而言，参与者在体重减轻阶段减重7.7千克，雌酮（-5.7%，P = 0.006）、雌二醇（-9.9%，P <0.001）、游离雌二醇（-13.4%，P <0.0001）和游离睾酮（-9.9%，P <0.0001）浓度下降，而SHBG浓度（16.2%，P <0.001）上升。体重变化对总睾酮或其他雄激素浓度没有显著影响。与非AA女性相比，AA女性每千克体重变化时雌激素变化较小（即每减重1千克：雌酮，-0.6%对-1.2%，P交互作用 = 0.10；雌二醇，-1.1%对-1.9%，P交互作用 = 0.04；SHBG，0.9%对1.6%，P交互作用 = 0.006；游离雌二醇，-1.4%对-2.1%，P交互作用 = 0.01）。
结论
据我们所知，这是第一项研究并比较有意减重及维持体重对AA女性和非AA女性一组性激素影响的研究。尽管只是推测，但这些数据表明激素差异可能导致乳腺癌发病率和死亡率存在不同的种族模式，并鼓励进一步研究以了解减重对肥胖绝经后女性性激素的长期影响。
试验注册
ClinicalTrials.gov：NCT00054925
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