雌二醇和孕酮对绝经后女性心血管危险因素的不同影响。
Differential Effects of Estradiol and Progesterone on Cardiovascular Risk Factors in Postmenopausal Women.
作者信息
Roelfsema Ferdinand, Yang Rebecca J, Veldhuis Johannes D
机构信息
Department of Internal Medicine, Section Endocrinology and Metabolism, Leiden University Medical Center, ZA Leiden, Netherlands.
Endocrine Research Unit, Mayo School of Graduate Medical Education, Center for Translational Science Activities, Mayo Clinic, Rochester, Minnesota.
出版信息
J Endocr Soc. 2018 Jun 14;2(7):794-805. doi: 10.1210/js.2018-00073. eCollection 2018 Jul 1.
CONTEXT
Controlled, blinded studies of sex-hormone replacement in postmenopausal women using natural estradiol (E) and native progesterone (P) are few.
OBJECTIVE
To delineate the effect of E alone or with P on lipids and inflammatory markers.
DESIGN
A placebo-controlled, double-masked, prospectively randomized study of 40 healthy, postmenopausal volunteers assigned to four treatment groups: placebo, intramuscular E, and/or micronized oral P for 23 (±2) days.
RESULTS
Treatment with E alone compared with placebo lowered total cholesterol (TC; = 0.006), non-high-density lipoprotein cholesterol (nonHDL-C; = 0.004), low-density lipoprotein cholesterol (LDL-C; = 0.012), and apolipoprotein B (Apo B; = 0.02) levels, and raised HDL-C levels ( = 0.03 the 3 other groups). Conversely, addition of P to E reduced HDL-C levels ( = 0.015). Triglyceride concentrations manifested no effect on E or P. High-sensitivity C-reactive protein (hsCRP) level was highest in women with E and P replacement ( = 0.018 placebo). Leptin and IL-6 concentrations did not vary. P treatment decreased adiponectin levels ( = 0.019). Serum E levels correlated linearly with TC, LDL-C, nonHDL-C, Apo B (all negatively), and SHBG (positively) concentrations. P level correlated negatively with TC ( = 0.029), HDL-C ( = 0.002), and adiponectin ( = 0.002) levels.
CONCLUSION
In this study, there were individual and interactive effects of E and P on key lipids in postmenopausal individuals.
背景
使用天然雌二醇（E）和天然孕酮（P）对绝经后女性进行性激素替代的对照、盲法研究较少。
目的
阐明单独使用E或联合P对脂质和炎症标志物的影响。
设计
一项安慰剂对照、双盲、前瞻性随机研究，将40名健康绝经后志愿者分为四个治疗组：安慰剂组、肌肉注射E组和/或微粉化口服P组，治疗23（±2）天。
结果
与安慰剂相比，单独使用E治疗可降低总胆固醇（TC；P = 0.006）、非高密度脂蛋白胆固醇（nonHDL-C；P = 0.004）、低密度脂蛋白胆固醇（LDL-C；P = 0.012）和载脂蛋白B（Apo B；P = 0.02）水平，并提高高密度脂蛋白胆固醇（HDL-C）水平（P = 0.03，优于其他三组）。相反，E联合P会降低HDL-C水平（P = 0.015）。甘油三酯浓度不受E或P的影响。高敏C反应蛋白（hsCRP）水平在接受E和P替代治疗的女性中最高（P = 0.018，高于安慰剂组）。瘦素和白细胞介素-6浓度无变化。P治疗可降低脂联素水平（P = 0.019）。血清E水平与TC、LDL-C、nonHDL-C、Apo B（均为负相关）和性激素结合球蛋白（SHBG）（正相关）浓度呈线性相关。P水平与TC（P = 0.029）、HDL-C（P = 0.002）和脂联素（P = 0.002）水平呈负相关。
结论
在本研究中，E和P对绝经后个体的关键脂质有个体和交互作用。
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