Jensen J, Christiansen C, Rødbro P
N Engl J Med. 1985 Oct 17;313(16):973-5. doi: 10.1056/NEJM198510173131602.
To elucidate the effect of smoking on estrogen metabolism, we examined 136 postmenopausal women treated for one year with one of three different doses of combined estrogen-progestogen or placebo. The women were grouped according to smoking status, and serum levels of estrone and estradiol were measured before and after treatment. The results showed reduced levels of both estrogens in smokers as compared with nonsmokers in all three dosage groups. This reduction was most pronounced in the high-dose group (4 mg of estradiol), in which the serum levels of estrone and estradiol in smokers were only 50 per cent of those in nonsmokers (P less than 0.001 and less than 0.05, respectively). In contrast, no significant changes could be demonstrated in the corresponding placebo groups. Moreover, it was possible to demonstrate significant inverse correlations between the number of cigarettes smoked daily and the changes in the levels of serum estrone and estradiol, respectively, (P less than 0.001). This study suggests that an increased hepatic metabolism of estrogens results in lower estrogen levels among postmenopausal smokers. This may contribute to the reported risk of osteoporosis among smokers.
为阐明吸烟对雌激素代谢的影响，我们对136名绝经后女性进行了研究，她们接受了三种不同剂量的雌激素 - 孕激素联合治疗或安慰剂治疗，为期一年。这些女性根据吸烟状况分组，在治疗前后测量血清雌酮和雌二醇水平。结果显示，在所有三个剂量组中，吸烟者体内这两种雌激素的水平均低于非吸烟者。这种降低在高剂量组（4毫克雌二醇）中最为明显，该组中吸烟者的血清雌酮和雌二醇水平仅为非吸烟者的50%（P分别小于0.001和小于0.05）。相比之下，相应的安慰剂组未显示出显著变化。此外，每日吸烟量与血清雌酮和雌二醇水平的变化之间分别存在显著的负相关（P小于0.001）。本研究表明，雌激素的肝脏代谢增加导致绝经后吸烟者体内雌激素水平降低。这可能是吸烟者中骨质疏松症风险增加的原因之一。
