Yamatani Hizuru, Takahashi Kazuhiro, Nagase Satoru
Nihon Rinsho. 2015 Apr;73(4):565-70.
Sex hormones as estrogen, testosterone, dehydroepiandrosterone decline with age. Especially in women, bioavailable estrogen level rapidly decreases around the menopause. Estrogen acts against arteriosclerosis to vascular endothelial cells and vascular smooth muscle cells. The lack of estrogen with menopause accelerates arteriosclerosis that is the leading cause of cardiovascular diseases. The adipose distribution shifts from gluteo-femoral to abdominal depots after menopause, and it is well known that visceral obesity induce metabolic syndrome, which is also high risk state for cardiovascular disease. Estrogen replacement therapy may reduce the cardiovascular risk, and we should pay attention to the starting age of women who undergo hormone therapy.
雌激素、睾酮、脱氢表雄酮等性激素会随着年龄增长而下降。尤其是女性,在绝经前后,生物可利用雌激素水平会迅速降低。雌激素对血管内皮细胞和血管平滑肌细胞具有抗动脉粥样硬化作用。绝经后雌激素缺乏会加速动脉粥样硬化,而动脉粥样硬化是心血管疾病的主要病因。绝经后脂肪分布从臀股部转移至腹部,众所周知,内脏肥胖会诱发代谢综合征,而代谢综合征也是心血管疾病的高危状态。雌激素替代疗法可能会降低心血管疾病风险,我们应该关注接受激素治疗女性的起始年龄。