Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Menopause. 2013 Jun;20(6):640-5. doi: 10.1097/GME.0b013e318279bd4a.
The relationships between endogenous sex hormone levels and cardiovascular disease risk in women are contentious. Our aim was to systematically investigate the relationships between sex steroids and lipid levels in postmenopausal women, taking into account other potential risk factors.
This is a cross-sectional study of 624 naturally and surgically postmenopausal women not using any systemic hormones or lipid-lowering therapy, with a mean (SD) age of 53.9 (5.8) years, who were recruited in the United States, Canada, Australia, UK, and Sweden between July 2004 and February 2005. The relationships between total testosterone, dihydrotestosterone, estrone, estradiol, sex hormone-binding globulin (SHBG), the homeostasis model assessment for insulin resistance (HOMA-IR), and each lipid variable were explored using multivariable linear regression.
None of the sex steroids measured made an independent contribution to the multivariable models for total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, non-HDL cholesterol, or triglycerides (TG). The best model for total cholesterol included race and age, and that for LDL cholesterol included race and blood pressure, with each model only explaining 4.8% and 3.3% of the variation in each lipid, respectively. About 7.7% of the variation in non-HDL cholesterol was explained by HOMA-IR, race, and SHBG. HOMA-IR, SHBG, age, and surgical menopause explained 22.8% of the variation in HDL cholesterol, whereas HOMA-IR, SHBG, race, and surgical menopause explained 25.4% of the variation in TG.
Endogenous estrogen and androgen levels are not independent predictors of lipid levels in postmenopausal women. HOMA-IR and SHBG each make independent contributions to HDL cholesterol and TG. These factors make little contribution to total and LDL cholesterol.
女性内源性性激素水平与心血管疾病风险之间的关系仍存在争议。我们旨在系统地研究绝经后女性中性类固醇激素与血脂水平之间的关系，同时考虑其他潜在的危险因素。
这是一项在美国、加拿大、澳大利亚、英国和瑞典于 2004 年 7 月至 2005 年 2 月间招募的 624 名自然绝经和手术绝经、未使用任何系统性激素或降脂治疗、平均（SD）年龄为 53.9（5.8）岁的绝经后妇女的横断面研究。采用多元线性回归方法探讨总睾酮、二氢睾酮、雌酮、雌二醇、性激素结合球蛋白（SHBG）、胰岛素抵抗稳态模型评估（HOMA-IR）与各血脂变量之间的关系。
在所测量的性激素中，没有一种能够独立预测总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、非高密度脂蛋白胆固醇或甘油三酯（TG）的多元线性回归模型。总胆固醇的最佳模型包括种族和年龄，而 LDL 胆固醇的最佳模型包括种族和血压，每个模型仅分别解释各血脂变异的 4.8%和 3.3%。HOMA-IR、种族和 SHBG 解释了非 HDL 胆固醇变异的约 7.7%。HOMA-IR、SHBG、年龄和手术绝经解释了 HDL 胆固醇变异的 22.8%，而 HOMA-IR、SHBG、种族和手术绝经解释了 TG 变异的 25.4%。
内源性雌激素和雄激素水平不是绝经后妇女血脂水平的独立预测因素。HOMA-IR 和 SHBG 各自对 HDL 胆固醇和 TG 有独立贡献。这些因素对总胆固醇和 LDL 胆固醇的贡献较小。
