Smith Gordon I, Reeds Dominic N, Okunade Adewole L, Patterson Bruce W, Mittendorfer Bettina
Washington University School of Medicine, St Louis, Missouri 63110.
J Clin Endocrinol Metab. 2014 Jul;99(7):E1306-10. doi: 10.1210/jc.2013-4470. Epub 2014 Apr 2.
Sexual dimorphism in plasma triglyceride (TG) metabolism is well established but it is unclear to what extent it is driven by differences in the sex hormone milieu. RESULTS from previous studies evaluating the effects of sex steroids on plasma TG homeostasis are inconclusive because they relied on orally administered synthetic hormone preparations or evaluated only plasma lipid concentrations but not kinetics.
The purpose of this study was to evaluate the effects of systemically delivered 17β-estradiol, progesterone, and T on very low density lipoprotein-triglyceride (VLDL-TG) concentration and kinetics in postmenopausal women.
VLDL-TG concentration and kinetics were evaluated by using stable isotope-labeled tracer techniques in four groups of postmenopausal women (n = 27 total) who were studied before and after treatment with either 17β-estradiol (0.1 mg/d via continuous delivery skin patch), progesterone (100 mg/d via vaginal insert) and T (12.5 mg/d via skin gel), or no intervention (control group).
VLDL-TG concentration and kinetics were unchanged in the control group and not altered by T and progesterone administration. Estradiol treatment, in contrast, reduced VLDL-TG concentration by approximately 30% due to accelerated VLDL-TG plasma clearance (25.1 ± 2.5 vs. 17.4 ± 2.7 mL/min; P < .01).
Estradiol, but not progesterone or T, is a major regulator of VLDL-TG metabolism.
血浆甘油三酯(TG)代谢中的性别差异已得到充分证实,但尚不清楚其在多大程度上受性激素环境差异的驱动。以往评估性类固醇对血浆TG稳态影响的研究结果尚无定论,因为这些研究依赖于口服合成激素制剂,或仅评估血浆脂质浓度而非动力学。
本研究的目的是评估全身给予17β-雌二醇、孕酮和睾酮对绝经后女性极低密度脂蛋白甘油三酯(VLDL-TG)浓度和动力学的影响。
采用稳定同位素示踪技术,对四组绝经后女性(共27例)的VLDL-TG浓度和动力学进行评估,这四组女性在接受17β-雌二醇(通过持续释放皮肤贴片给予,0.1mg/d)、孕酮(通过阴道栓剂给予,100mg/d)和睾酮(通过皮肤凝胶给予,12.5mg/d)治疗前后进行研究,另一组为未干预的对照组。
对照组的VLDL-TG浓度和动力学未发生变化,给予睾酮和孕酮后也未改变。相比之下,雌二醇治疗使VLDL-TG浓度降低了约30%,这是由于VLDL-TG血浆清除率加快(25.1±2.5对17.4±2.7mL/min;P<.01)。
雌二醇是VLDL-TG代谢的主要调节因子,而孕酮和睾酮不是。