女性血浆雌激素水平与动脉瘤性蛛网膜下腔出血
Plasma Estrogen Levels and Aneurysmal Subarachnoid Hemorrhage in Women.
作者信息
Lai Pui Man Rosalind, Jimenez Monik, Rexrode Kathryn, Du Rose
机构信息
Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
出版信息
World Neurosurg. 2024 Dec;192:e267-e272. doi: 10.1016/j.wneu.2024.09.083. Epub 2024 Oct 9.
OBJECTIVE
Aneurysmal subarachnoid hemorrhage (aSAH) is more prevalent in postmenopausal women, and it has been postulated that this relationship is hormonally driven by lower circulating levels of estrogens. We examined the association between circulating plasma estrogen levels and subsequent development of aSAH in women.
METHODS
Women from the Nurses' Health Study with confirmed aSAH (n = 38) were matched with controls (n = 38) on age, smoking, menopausal status, and other reproductive factors. Plasma estriol, estradiol, and sex hormone-binding globulin were measured at baseline, prior to the development of aSAH. Conditional logistic regressions were performed to assess the association between hormone levels and incident aSAH.
RESULTS
Plasma estradiol, estriol, and sex hormone-binding globulin were not associated with the subsequent development of aSAH. Women with a history of current or former smoking were associated with lower levels of circulating estriol (β = -0.35 ± 0.12, P = 0.004) and estradiol (β = -0.63 ± 0.16, P = 0.0002).
CONCLUSIONS
In this study, we did not find an association between estrogen levels and the incidence of aSAH in women.
目的
动脉瘤性蛛网膜下腔出血（aSAH）在绝经后女性中更为常见，据推测这种关系是由雌激素循环水平降低所驱动的激素因素导致的。我们研究了女性循环血浆雌激素水平与随后发生aSAH之间的关联。
方法
来自护士健康研究的确诊aSAH女性（n = 38）与对照组（n = 38）在年龄、吸烟、绝经状态和其他生殖因素方面进行匹配。在aSAH发生之前，于基线时测量血浆雌三醇、雌二醇和性激素结合球蛋白。进行条件逻辑回归以评估激素水平与aSAH发病之间的关联。
结果
血浆雌二醇、雌三醇和性激素结合球蛋白与随后发生的aSAH无关。有当前或既往吸烟史的女性循环雌三醇水平较低（β = -0.35 ± 0.12，P = 0.004），雌二醇水平也较低（β = -0.63 ± 0.16，P = 0.0002）。
结论
在本研究中，我们未发现雌激素水平与女性aSAH发病率之间存在关联。
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