Jung Jae H, Song Gwan G, Lee Young H, Kim Jae-Hoon, Hyun Myung H, Choi Sung J
Korea University College of Medicine, Seoul, Korea.
Department of Rheumatology, Korea University Guro Hospital, Seoul, Korea.
Menopause. 2018 Jan;25(1):77-81. doi: 10.1097/GME.0000000000000953.
Serum uric acid levels increase in postmenopausal women, but decrease when hormone therapy (HT) is administered. No study has, however, evaluated the effects of different types of HT on serum uric acid levels. We therefore examined whether estrogen therapy (ET), estrogen plus progestogen therapy (EPT), and tibolone use affected serum uric acid levels in this population.
We performed a retrospective cohort study of postmenopausal women. From 2005 to 2015, postmenopausal women who had undergone blood uric acid-level testing at least twice were enrolled. Participants were grouped according to HT regimen: ET, EPT, or tibolone. The nonhormone therapy group did not receive HT. Differences in serum uric acid levels were examined in each group. Our analysis was adjusted to accommodate different follow-up intervals for individual participants. Multiple variables were adjusted using the Tukey-Kramer method. Age, body mass index, hypertension, diabetes mellitus, dyslipidemia, estimated glomerular filtration rate, alcohol consumption, smoking status, and comedications were also adjusted.
After adjusting for multiple variables, the serum uric acid level increased to 0.87 ± 0.27 mg/dL (least squares mean ± standard error) in the nonhormone therapy group, and serum uric levels in the EPT group were found to be significantly lower (-0.38 ± 0.29 mg/dL, P < 0.001). The serum uric acid levels in the ET and tibolone groups did not, however, differ significantly from the nonhormone therapy group level.
We attribute our findings to the effects of progestogen, rather than estrogen.
绝经后女性血清尿酸水平会升高,但进行激素治疗(HT)时则会降低。然而,尚无研究评估不同类型的HT对血清尿酸水平的影响。因此,我们研究了雌激素治疗(ET)、雌激素加孕激素治疗(EPT)和替勃龙的使用是否会影响该人群的血清尿酸水平。
我们对绝经后女性进行了一项回顾性队列研究。纳入了2005年至2015年间至少进行过两次血尿酸水平检测的绝经后女性。参与者根据HT方案分组:ET、EPT或替勃龙。非激素治疗组未接受HT。检查了每组血清尿酸水平的差异。我们的分析进行了调整,以适应个体参与者不同的随访间隔。使用Tukey-Kramer方法对多个变量进行了调整。还对年龄、体重指数、高血压、糖尿病、血脂异常、估计肾小球滤过率、饮酒、吸烟状况和合并用药进行了调整。
在对多个变量进行调整后,非激素治疗组的血清尿酸水平升至0.87±0.27mg/dL(最小二乘均值±标准误差),发现EPT组的血清尿酸水平显著较低(-0.38±0.29mg/dL,P<0.001)。然而,ET组和替勃龙组的血清尿酸水平与非激素治疗组水平无显著差异。
我们将研究结果归因于孕激素而非雌激素的作用。