绝经前女性的月经周期特征及甾体激素、催乳素和生长因子水平
Menstrual cycle characteristics and steroid hormone, prolactin, and growth factor levels in premenopausal women.
作者信息
Farland Leslie V, Mu Fan, Eliassen A Heather, Hankinson Susan E, Tworoger Shelley S, Barbieri Robert L, Dowsett Mitch, Pollak Michael N, Missmer Stacey A
机构信息
Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA.
出版信息
Cancer Causes Control. 2017 Dec;28(12):1441-1452. doi: 10.1007/s10552-017-0971-2. Epub 2017 Oct 31.
PURPOSE
Menstrual cycle characteristics are markers of endocrine milieu. However, associations between age at menarche and adulthood sex steroid hormone levels have been inconsistent, and data on menstrual characteristics and non-sex steroid hormones are sparse.
METHODS
We assessed the relations of menstrual characteristics with premenopausal plasma sex steroid hormones, sex hormone binding globulin (SHBG), prolactin, and growth factors among 2,745 premenopausal women (age 32-52) from the Nurses' Health Study II. Geometric means and tests for trend were calculated using multivariable general linear models.
RESULTS
Early age at menarche was associated with higher premenopausal early-follicular free estradiol (percent difference < 12 vs. > 13 years = 11%), early-follicular estrone (7%), luteal estrone (7%), and free testosterone (8%) (all p < 0.05). Short menstrual cycle length at age 18-22 was associated with higher early-follicular total (< 26 vs. > 39 days = 18%) and free estradiol (16%), early-follicular estrone (9%), SHBG (7%), lower luteal free estradiol (- 14%), total (- 6%), and free testosterone (- 15%) (all p < 0.05). Short adult menstrual length was associated with higher early-follicular total estradiol (< 26 vs. > 31 days = 14%), SHBG (10%), lower luteal estrone (- 8%), progesterone (- 9%), total (- 11%) and free testosterone (- 25%), and androstenedione (- 14%) (all p < 0.05). Irregularity of menses at 18-22 was associated with lower early-follicular total (irregular vs. very regular = - 14%) and free estradiol (- 14%), and early-follicular estrone (- 8%) (All p < 0.05). Irregularity of adult menstrual cycle was associated with lower luteal total estradiol (irregular vs. very regular = - 8%), SHBG (- 3%), higher total (8%), and free testosterone (11%) (all p < 0.05).
CONCLUSIONS
Early-life and adulthood menstrual characteristics are moderately associated with mid-to-late reproductive year's hormone concentrations. These relations of menstrual characteristics with endogenous hormone levels could partially account for associations between menstrual characteristics and reproductive cancers or other chronic diseases.
目的
月经周期特征是内分泌环境的标志。然而，初潮年龄与成年期性类固醇激素水平之间的关联并不一致，而且关于月经特征与非性类固醇激素的数据很少。
方法
我们评估了来自护士健康研究II的2745名绝经前女性（年龄32 - 52岁）的月经特征与绝经前血浆性类固醇激素、性激素结合球蛋白（SHBG）、催乳素和生长因子之间的关系。使用多变量一般线性模型计算几何均值和趋势检验。
结果
初潮年龄早与绝经前卵泡早期游离雌二醇水平较高相关（初潮年龄<12岁与>13岁相比，差异百分比 = 11%）、卵泡早期雌酮（7%）、黄体期雌酮（7%）和游离睾酮（8%）（所有p<0.05）。18 - 22岁时月经周期短与卵泡早期总雌二醇（周期<26天与>39天相比，差异百分比 = 18%）和游离雌二醇（16%）、卵泡早期雌酮（9%）、SHBG（7%）水平较高相关，黄体期游离雌二醇水平较低（-14%）、总雌二醇水平较低（-6%）和游离睾酮水平较低（-15%）（所有p<0.05）。成年期月经周期短与卵泡早期总雌二醇水平较高相关（周期<26天与>31天相比，差异百分比 = 14%）、SHBG（10%）水平较高，黄体期雌酮水平较低（-8%）、孕酮水平较低（-9%）、总雌二醇水平较低（-11%）和游离睾酮水平较低（-25%）以及雄烯二酮水平较低（-14%）（所有p<0.05）。18 - 22岁月经不规律与卵泡早期总雌二醇水平较低（不规律与非常规律相比，差异百分比 = -14%）和游离雌二醇水平较低（-14%）以及卵泡早期雌酮水平较低（-8%）相关（所有p<0.05）。成年期月经周期不规律与黄体期总雌二醇水平较低（不规律与非常规律相比，差异百分比 = -8%）、SHBG水平较低（-3%）、总睾酮水平较高（8%）和游离睾酮水平较高（11%）相关（所有p<0.05）。
结论
生命早期和成年期的月经特征与生殖中后期的激素浓度存在中度关联。月经特征与内源性激素水平之间的这些关系可能部分解释了月经特征与生殖系统癌症或其他慢性疾病之间的关联。
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