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为期 3 周的脱氢表雄酮给药对绝经后妇女睡眠、性激素和多种 24 小时激素谱的影响:一项初步研究。

Effects of a 3-week dehydroepiandrosterone administration on sleep, sex steroids and multiple 24-h hormonal profiles in postmenopausal women: a pilot study.

机构信息

Laboratory of Physiology and Physiopathology, Université Libre de Bruxelles, Brussels, Belgium; Section of Endocrinology of the Centre Hospitalo-Universitaire Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.

出版信息

Clin Endocrinol (Oxf). 2013 Nov;79(5):716-24. doi: 10.1111/cen.12201. Epub 2013 Apr 23.

Abstract

OBJECTIVE

Dehydroepiandrosterone (DHEA) administration is widely evocated as a 'fountain of youth', but previous studies have provided inconsistent results. We aimed to investigate in healthy postmenopausal women the effects of a 3-week oral DHEA administration on individual steroid levels, multiple 24-h hormonal profiles and sleep architecture.

DESIGN

Seven healthy nonobese postmenopausal women, off hormone replacement therapy for ≥2 months, were investigated in a randomized, crossover, double-blind, placebo-controlled study. For 3 weeks, subjects took daily at 2300 h a capsule of either 50 mg DHEA or placebo. Sleep was polygraphically recorded during the last two nights, and blood samples were drawn at 15-min intervals during the last 24 h.

RESULTS

Under DHEA, testosterone and estradiol levels were increased in all individuals. Individual increments were highly variable, not related to each other, and were not related to placebo values. However, the testosterone to estradiol ratio was markedly increased under DHEA. DHEA administration had little, if any, effect on thyroid function, GH secretion, prolactin, ACTH and cortisol profiles. DHEA effects on sleep appeared to be mediated by its conversion to androgens and oestrogens: sleep quality was enhanced by increments in testosterone and dampened by increments in estradiol levels.

CONCLUSION

As DHEA-induced elevations in testosterone and estradiol levels varied widely between individuals and were largely unpredictable, DHEA administration might not be the most appropriate approach to compensate for the reduction observed in androgen and oestrogen production in postmenopausal women. DHEA supplementation may result either in sleep stimulation or in inhibition, depending on the ratio between DHEA-induced increments in testosterone vs estradiol.

摘要

目的

脱氢表雄酮(DHEA)的应用被广泛认为是“青春之泉”,但之前的研究结果并不一致。我们旨在研究健康绝经后妇女口服 DHEA 3 周对个体类固醇水平、多种 24 小时激素谱和睡眠结构的影响。

设计

7 名健康、非肥胖绝经后妇女,停用激素替代疗法≥2 个月,进行随机、交叉、双盲、安慰剂对照研究。在 3 周内,受试者每天 23:00 服用 50mg DHEA 或安慰剂胶囊。在最后两晚进行多导睡眠图记录,在最后 24 小时内每 15 分钟抽取一次血样。

结果

在 DHEA 作用下,所有个体的睾酮和雌二醇水平均升高。个体增量差异很大,彼此之间没有相关性,也与安慰剂值无关。然而,睾酮与雌二醇的比值在 DHEA 作用下明显增加。DHEA 对甲状腺功能、GH 分泌、催乳素、ACTH 和皮质醇谱几乎没有影响。DHEA 对睡眠的影响似乎是通过其转化为雄激素和雌激素介导的:睾酮水平的升高可改善睡眠质量,而雌二醇水平的升高则会降低睡眠质量。

结论

由于 DHEA 诱导的睾酮和雌二醇水平升高在个体之间差异很大,且在很大程度上不可预测,因此 DHEA 给药可能不是补偿绝经后妇女雄激素和雌激素生成减少的最适当方法。DHEA 补充可能导致睡眠刺激或抑制,这取决于 DHEA 诱导的睾酮与雌二醇增量之间的比值。

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