Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands.
J Clin Endocrinol Metab. 2018 Apr 1;103(4):1622-1630. doi: 10.1210/jc.2017-02421.
Polycystic ovary syndrome (PCOS) is closely linked to hyperandrogenism (HA). In PCOS, HA has been associated with metabolic disturbances that increase the risk for cardiovascular disease (CVD).
To assess the association of high serum androgen levels, as a postmenopausal remnant of PCOS, with the prevalence of atherosclerosis and incidence of CVD in postmenopausal women.
The Rotterdam Study, a prospective population-based cohort study. Median follow-up was 11.36 years.
General community.
A total of 2578 women aged >55 years. Exclusion criteria were missing informed consent or follow-up data, perimenopausal status, and menopause by surgical intervention or at an unnatural age (age <40 or >62).
None.
Linear, logistic, and Cox regression models assessed the association of top quartiles (P75) of serum testosterone, free androgen index (FAI), dehydroepiandrosterone, and androstenedione and sex hormone-binding globulin with coronary artery calcium, carotid intima-media thickness (IMT), pulse wave velocity, peripheral artery disease, and incidence of coronary heart disease (CHD), stroke, and CVD.
Mean age (standard deviation) was 70.19 (8.71) years, and average time since menopause was 19.85 (9.94) years. Highest quartile FAI was associated with higher pulse wave velocity (β [95% confidence interval (CI)], 0.009 [0.000 to 0.018]). Highest quartile dehydroepiandrosterone [β (95% CI), -0.008 (-0.015 to -0.001)] and androstenedione [β (95% CI), -0.010 (-0.017 to -0.003)] levels were associated with a lower IMT. We found no association between high androgen levels and incident stroke, CHD, or CVD.
Postmenopausal high androgen levels were not associated with an elevated risk for CVD. Cardiovascular health in women with PCOS might be better than was anticipated.
多囊卵巢综合征（PCOS）与高雄激素血症（HA）密切相关。在 PCOS 中，HA 与代谢紊乱有关，这会增加心血管疾病（CVD）的风险。
评估血清雄激素水平升高（作为 PCOS 的绝经后残留）与绝经后妇女动脉粥样硬化的患病率和 CVD 的发生率之间的关系。
鹿特丹研究，一项前瞻性人群为基础的队列研究。中位随访时间为 11.36 年。
一般社区。
共 2578 名年龄>55 岁的女性。排除标准为未获得知情同意或随访数据、围绝经期状态以及因手术干预或非自然年龄（<40 岁或>62 岁）而绝经。
无。
线性、逻辑和 Cox 回归模型评估了血清睾酮、游离雄激素指数（FAI）、脱氢表雄酮、雄烯二酮和性激素结合球蛋白的前四分位数（P75）与冠状动脉钙化、颈动脉内膜-中层厚度（IMT）、脉搏波速度、外周动脉疾病以及冠心病（CHD）、卒中和 CVD 的发生率之间的关系。
平均年龄（标准差）为 70.19（8.71）岁，绝经后平均时间为 19.85（9.94）年。最高四分位 FAI 与较高的脉搏波速度相关（β[95%置信区间（CI）]，0.009[0.000 至 0.018]）。最高四分位脱氢表雄酮[β（95%CI），-0.008（-0.015 至 -0.001）]和雄烯二酮[β（95%CI），-0.010（-0.017 至 -0.003）]水平与较低的 IMT 相关。我们没有发现高水平雄激素与卒中、CHD 或 CVD 的发生之间存在关联。
绝经后高雄激素水平与 CVD 风险增加无关。PCOS 女性的心血管健康可能比预期的要好。
