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生殖年龄段女性心血管和代谢危险因素的聚类分析。

Cluster analysis of cardiovascular and metabolic risk factors in women of reproductive age.

机构信息

Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.

Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.

出版信息

Fertil Steril. 2014 May;101(5):1404-10. doi: 10.1016/j.fertnstert.2014.01.023. Epub 2014 Feb 15.

Abstract

OBJECTIVE

To study the association between endocrine disturbances and metabolic complications in women seeking gynecologic care.

DESIGN

Retrospective study, cluster analysis.

SETTING

Outpatient clinic, university medical center.

PATIENT(S): 573 women, including 384 at low risk and 189 at high risk of cardiometabolic disease.

INTERVENTION(S): None.

MAIN OUTCOME MEASURE(S): Cardiovascular and metabolic parameters and clinical and biochemical characteristics.

RESULT(S): Risk factors for metabolic disease are associated with a low age of menarche, high levels of high-sensitivity C-reactive protein and liver enzymes, and low levels of sex hormone-binding globulin. Overweight/obese status, polycystic ovary syndrome, oligo/amenorrhea, and hyperandrogenism were found to increase the risk of cardiometabolic disease. However, hyperprolactinemia and premature ovarian failure were not associated with the risk of cardiometabolic disease. In terms of androgens, the serum total testosterone level and free androgen index but not androstenedione or dehydroepiandrosterone sulfate (DHEAS) were associated with cardiometabolic risk.

CONCLUSION(S): Although polycystic ovary syndrome is associated with metabolic risk, obesity was the major determinant of cardiometabolic disturbances in reproductive-aged women. Hyperprolactinemia and premature ovarian failure were not associated with the risk of cardiovascular and metabolic diseases.

CLINICAL TRIAL REGISTRATION NUMBER

NCT01826357.

摘要

目的

研究妇科就诊女性内分泌紊乱与代谢并发症之间的关系。

设计

回顾性研究,聚类分析。

地点

大学医学中心门诊诊所。

患者

573 名女性,包括 384 名低危患者和 189 名心血管代谢疾病高危患者。

干预措施

无。

主要观察指标

心血管和代谢参数以及临床和生化特征。

结果

代谢疾病的危险因素与月经初潮年龄较低、高敏 C 反应蛋白和肝酶水平较高以及性激素结合球蛋白水平较低有关。超重/肥胖、多囊卵巢综合征、少/闭经和高雄激素血症会增加患心血管代谢疾病的风险。然而,高催乳素血症和卵巢早衰与心血管代谢疾病的风险无关。就雄激素而言,血清总睾酮水平和游离雄激素指数与心血管代谢风险相关,但与雄烯二酮或硫酸脱氢表雄酮(DHEAS)无关。

结论

尽管多囊卵巢综合征与代谢风险相关,但肥胖是生殖期女性心血管代谢紊乱的主要决定因素。高催乳素血症和卵巢早衰与心血管和代谢疾病的风险无关。

临床试验注册号

NCT01826357。

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