Matsui Sumika, Yasui Toshiyuki, Kasai Kana, Yoshida Kanako, Kato Takeshi, Uemura Hirokazu, Kuwahara Akira, Matsuzaki Toshiya, Irahara Minoru
a Department of Obstetrics and Gynecology, Institute of Biomedical Sciences , Tokushima University Graduate School , Tokushima , Japan.
b Department of Reproductive and Menopausal Medicine, Institute of Biomedical Sciences , Tokushima University Graduate School , Tokushima , Japan.
J Obstet Gynaecol. 2018 Feb;38(2):231-235. doi: 10.1080/01443615.2017.1344829. Epub 2017 Sep 14.
The aim of this study was to determine the effect of hormone replacement therapy (HRT) on changes in circulating dehydroepiandrosterone-sulphate (DHEA-S) with focus on the relationship between oestrogen level and change in DHEA-S. Forty-two women were enrolled in this longitudinal study. Nineteen women received oral oestradiol and twenty-three women received transdermal oestradiol continuously. Twenty women received progesterone continuously except for women who had undergone hysterectomy. Circulating oestradiol, follicle-stimulating hormone, luteinising hormone and DHEA-S levels before and at 3 months after commencement of HRT were measured. Circulating DHEA-S level was significantly decreased at 3 months (p < .001). Oestradiol level at 3 months ranged from 6.5 pg/ml to 159 pg/ml. There was no significant correlation of ΔDHEA-S (DHEAS level at 3 months-DHEA-S level at baseline) with Δoestradiol (r = 0.114, p = .471). Circulating DHEA-S level was significantly decreased at 3 months in all the four quartiles and divided according to Δoestradiol, and ΔDHEA-S did not show significant differences. In conclusion, circulating DHEA-S decreases even with a slight increase in oestradiol level. Impact statement What is already known on this subject: A transient increase in DHEA-S in women during the menopausal transition may be involved in the occurrence of menopausal symptoms and/or unfavourable metabolic changes. Hormone replacement therapy decreases circulating DHEA-S level. However, dose dependency of the change in DHEA-S on oestrogen has not been reported. What the results of this study add: Circulating DHEA-S decreases even with a slight increase in oestradiol level. What the implications are of these findings for clinical practice and/or further research: Adrenal function may respond to a small change in oestrogen.
本研究的目的是确定激素替代疗法(HRT)对循环脱氢表雄酮硫酸盐(DHEA-S)变化的影响,重点关注雌激素水平与DHEA-S变化之间的关系。42名女性参与了这项纵向研究。19名女性接受口服雌二醇,23名女性持续接受经皮雌二醇治疗。除接受子宫切除术的女性外,20名女性持续接受孕激素治疗。在HRT开始前及开始后3个月测量循环雌二醇、促卵泡激素、促黄体生成素和DHEA-S水平。3个月时循环DHEA-S水平显著降低(p<0.001)。3个月时雌二醇水平在6.5 pg/ml至159 pg/ml之间。ΔDHEA-S(3个月时的DHEAS水平-基线时的DHEA-S水平)与Δ雌二醇之间无显著相关性(r=0.114,p=0.471)。在所有四个四分位数中,3个月时循环DHEA-S水平均显著降低,并根据Δ雌二醇进行划分,且ΔDHEA-S未显示出显著差异。总之,即使雌激素水平略有升高,循环DHEA-S也会降低。影响声明关于该主题已知的信息:围绝经期女性DHEA-S的短暂升高可能与绝经症状的发生和/或不良代谢变化有关。激素替代疗法会降低循环DHEA-S水平。然而,尚未报道DHEA-S变化对雌激素的剂量依赖性。本研究的结果补充了什么:即使雌激素水平略有升高,循环DHEA-S也会降低。这些发现对临床实践和/或进一步研究有何意义:肾上腺功能可能对雌激素的微小变化做出反应。