Ke Yuyong, Bélanger Alain, Simard Jean-Nicolas, Gonthier Renaud, Martel Céline, Vaillancourt Mario, Labrie Fernand
Endoceutics, Inc., Quebec City, Canada.
Laval University, Quebec City, Canada.
Menopause. 2018 Mar;25(3):293-300. doi: 10.1097/GME.0000000000000993.
The aim of the study was to determine the range of serum sex-related steroids in normal postmenopausal women and in women of the same age with a diagnosis of vulvovaginal atrophy (VVA).
Validated mass spectrometry-based assays coupled to gas or liquid chromatography were used over a 10-year period for steroid measurements. Serum samples were obtained in up to 1,512 women aged 55 to 65 years.
Serum estrone sulfate (E1S) and androsterone glucuronide (ADT-G), the main metabolites of estrogens and androgens, respectively, were 16.9% (P = 0.005) and 16.1% (P = 0.001) higher in women not diagnosed with moderate/severe VVA than those diagnosed with VVA. Serum estrone (E1) was 14.5% (P < 0.0001) higher in women with no diagnosis of VVA, whereas the other steroids did not show meaningful differences. The limited biological significance of serum estradiol (E2) and testosterone is supported by the lack of statistical significance in the serum concentrations of these two steroids between the two groups. Most importantly, for the women without a diagnosis of VVA, the normal upper limit (95 centile) of serum E2 was 9.15 pg/mL (n = 364) and 10.7 pg/mL (n = 67) for a weighted average of 9.99 pg E2/mL. A limit of 10 pg E2/mL has recently been found by two other laboratories. When comparing 50- to 59-year-old and 70- to 79-year-old women, serum E2, E1S, ADT-G, and DHEA were, respectively, 24.4%, 22.6%, 27.0%, and 85.9% higher in the younger group.
Somewhat higher values, namely, 16.9% and 16.1%, are observed in the serum concentrations of the estrogen (E1S) and androgen (ADT-G) metabolites in normal compared with women with a diagnosis of VVA. Such data indicating a lower estrogenic and androgenic global exposure in women diagnosed with VVA offers an opportunity for the local intravaginal administration of DHEA to replace the deficiency in endogenous DHEA.
本研究旨在确定正常绝经后女性以及患有外阴阴道萎缩（VVA）的同龄女性血清中与性别相关类固醇的范围。
在10年期间，使用经过验证的基于质谱的检测方法结合气相或液相色谱法进行类固醇测量。收集了多达1512名年龄在55至65岁之间女性的血清样本。
雌激素和雄激素的主要代谢产物血清硫酸雌酮（E1S）和雄酮葡糖苷酸（ADT-G），在未诊断为中度/重度VVA的女性中分别比诊断为VVA的女性高16.9%（P = 0.005）和16.1%（P = 0.001）。未诊断为VVA的女性血清雌酮（E1）高14.5%（P < 0.0001），而其他类固醇没有显著差异。两组之间这两种类固醇血清浓度缺乏统计学意义，支持了血清雌二醇（E2）和睾酮的生物学意义有限。最重要的是，对于未诊断为VVA的女性，血清E2的正常上限（第95百分位数）为9.15 pg/mL（n = 364）和10.7 pg/mL（n = 67），加权平均值为9.99 pg E2/mL。另外两个实验室最近发现E2的上限为10 pg/mL。比较50至59岁和70至79岁女性时，年轻组的血清E2、E1S、ADT-G和脱氢表雄酮（DHEA）分别高24.4%、22.6%、27.0%和85.9%。
与诊断为VVA的女性相比，正常女性血清中雌激素（E1S）和雄激素（ADT-G）代谢产物的浓度观察到略高的值，即分别高16.9%和16.1%。这些数据表明诊断为VVA的女性雌激素和雄激素的总体暴露较低，这为局部阴道内给予脱氢表雄酮以替代内源性脱氢表雄酮缺乏提供了机会。
