From the Department of Epidemiology (M.G., B.M., O.L.R.-O., E.A., M.K., M.K.I., M.W.V., M.A.I., O.H.F., D.B., T.M.), Department of Obstetrics and Gynaecology (J.S.E.L.), Department of Neurology (M.K.I., M.A.I.), and Department of Radiology and Nuclear Medicine (M.W.V., M.A.I., D.B.), Erasmus MC, Rotterdam, The Netherlands.
Circ Res. 2018 Jan 5;122(1):97-105. doi: 10.1161/CIRCRESAHA.117.311681. Epub 2017 Nov 2.
Sex steroids may play a role in plaque composition and in stroke incidence.
To study the associations of endogenous estradiol and testosterone with carotid plaque composition in elderly men and postmenopausal women with carotid atherosclerosis, as well as with risk of stroke in this population.
Data of 1023 postmenopausal women and 1124 men (≥45 years) with carotid atherosclerosis, from prospective population-based RS (Rotterdam Study), were available. At baseline, total estradiol (TE) and total testosterone (TT) were measured. Carotid atherosclerosis was assessed by ultrasound, whereas plaque composition (presence of calcification, lipid core, and intraplaque hemorrhage) was assessed by magnetic resonance imaging. TE and TT were not associated with calcified carotid plaques in either sex. TE was associated with presence of lipid core in both sexes (in women odds ratio, 1.48 [95% confidence interval [CI], 1.02-2.15]; in men odds ratio, 1.23 [95% CI, 1.03-1.46]), whereas no association was found between TT and lipid core in either sex. Higher TE (odds ratio, 1.58 [95% CI, 1.03-2.40]) and lower TT (odds ratio, 0.82 [95% CI, 0.68-0.98]) were associated with intraplaque hemorrhage in women but not in men. In women, TE was associated with increased risk of stroke (hazard ratio, 1.98 [95% CI, 1.01-3.88]), whereas no association was found in men. TT was not associated with risk of stroke in either sex.
TE was associated with presence of vulnerable carotid plaque as well as increased risk of stroke in women, whereas no consistent associations were found for TT in either sex.
性激素可能在斑块成分和中风发病中起作用。
研究内源性雌二醇和睾酮与老年男性和绝经后妇女颈动脉粥样硬化患者颈动脉斑块成分的关系，以及在该人群中与中风风险的关系。
前瞻性人群研究 RS（鹿特丹研究）中，有 1023 名绝经后妇女和 1124 名（≥45 岁）男性颈动脉粥样硬化患者的数据。基线时，测量了总雌二醇（TE）和总睾酮（TT）。颈动脉粥样硬化通过超声评估，而斑块成分（钙化、脂质核心和斑块内出血）通过磁共振成像评估。在两性中，TE 和 TT 均与钙化性颈动脉斑块无关。TE 与两性的脂质核心存在相关（女性比值比，1.48 [95%置信区间 [CI]，1.02-2.15]；男性比值比，1.23 [95% CI，1.03-1.46]），而 TT 在两性中与脂质核心之间均无关联。较高的 TE（比值比，1.58 [95% CI，1.03-2.40]）和较低的 TT（比值比，0.82 [95% CI，0.68-0.98]）与女性的斑块内出血相关，但在男性中则没有。在女性中，TE 与中风风险增加相关（风险比，1.98 [95% CI，1.01-3.88]），而在男性中则没有关联。TT 与两性的中风风险均无关联。
TE 与易损性颈动脉斑块的存在以及女性中风风险的增加相关，而 TT 在两性中均无一致的关联。
