Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Womens Health (Larchmt). 2022 Jul;31(7):1057-1065. doi: 10.1089/jwh.2021.0248. Epub 2022 Jun 8.
Low endogenous estrogen concentrations after menopause may contribute to higher oxidative stress and greater cardiovascular disease (CVD) risk. However, differences in oxidative stress between similarly aged premenopausal and postmenopausal women are not well-characterized on a population level. We hypothesized that urinary isoprostane concentrations, a standard measure of systemic oxidative stress, are higher in women who have undergone menopause compared to premenopausal women. We examined differences in urinary 8-isoprostane (iPF-III) and 2,3-dinor-8-isoprostane (iPF-III-M) indexed to urinary creatinine between 279 postmenopausal and 196 premenopausal women in the Coronary Artery Risk Development in Young Adults (CARDIA) study, using linear regression with progressive adjustment for sociodemographic factors and traditional CVD risk factors. Unadjusted iPF-III-M concentrations were higher among postmenopausal compared to premenopausal women (Median [25th, 75th percentile]: 1762 [1178, 2974] vs. 1535 [1067, 2462] ng/g creatinine; = 0.01). Menopause was associated with 25.5% higher iPF-III-M (95% confidence interval [6.5-47.9]) adjusted for age, race, college education, and field center. Further adjustments for tobacco use (21.2% [2.9-42.6]) and then CVD risk factors (18.8% [0.1-39.6]) led to additional partial attenuation. Menopause was associated with higher iPF-III in Black but not White women. We conclude that postmenopausal women had higher oxidative stress, which may contribute to greater CVD risk. ClinicalTrials.gov Identifier: NCT00005130.
绝经后内源性雌激素浓度降低可能导致更高的氧化应激和更大的心血管疾病 (CVD) 风险。然而,在人群水平上,绝经前和绝经后女性的氧化应激差异尚未得到很好的描述。我们假设,与绝经前女性相比,经历过绝经的女性尿液中异前列腺素浓度(衡量全身氧化应激的标准)更高。我们使用线性回归,对冠状动脉风险发展在年轻人(CARDIA)研究中的 279 名绝经后和 196 名绝经前女性的尿液 8-异前列腺素(iPF-III)和 2,3-二去甲-8-异前列腺素(iPF-III-M)与尿肌酐比值进行了差异分析,同时对社会人口统计学因素和传统 CVD 危险因素进行了逐步调整。与绝经前女性相比,未调整的 iPF-III-M 浓度在绝经后女性中更高(中位数 [25 分位,75 分位]:1762 [1178, 2974] vs. 1535 [1067, 2462]ng/g 肌酐; = 0.01)。调整年龄、种族、大学教育和研究中心后,绝经与 iPF-III-M 增加 25.5%(95%置信区间 [6.5-47.9])相关。进一步调整吸烟(21.2% [2.9-42.6])和 CVD 危险因素(18.8% [0.1-39.6])后,部分相关性进一步减弱。绝经与黑人女性而非白人女性的 iPF-III 升高相关。我们的结论是,绝经后女性氧化应激水平更高,这可能导致更大的 CVD 风险。临床试验注册号:NCT00005130。