Haffner S M, Newcomb P A, Marcus P M, Klein B E, Klein R
Department of Medicine, University of Texas Health Science Center at San Antonio, USA.
Am J Epidemiol. 1995 Nov 1;142(9):925-34. doi: 10.1093/oxfordjournals.aje.a117740.
Sex hormones play a major role in determining the risk of cardiovascular disease. While several studies have shown that reduced sex hormone-binding globulin is associated with an atherogenic pattern of lipoproteins and increased glucose concentrations in premenopausal women, little data are available examining the association of sex hormone-binding globulin and sex hormones with cardiovascular risk factors in postmenopausal women, a group with high rates of cardiovascular disease. The investigators hypothesized that in postmenopausal women decreased sex hormone-binding globulin and increased testosterone would be associated with an atherogenic pattern of cardiovascular risk factors. The sex hormone-binding globulin, total and free testosterone, estrone, and dehydroepiandrosterone sulfate (DHEA-SO4) in 253 postmenopausal women who were not taking hormones were measured in a population-based study, the Beaver Dam Eye Study (Beaver Dam, Wisconsin, 1988-1990). Sex hormone-binding globulin was significantly inversely correlated with body mass index (r = -0.53, p 0.001), glycosylated hemoglobin (r = -0.34, p < 0.001), and diastolic blood pressure (r = -0.25, p < 0.001), and positively correlated with high density lipoprotein cholesterol (HDL cholesterol) (r = 0.31, p < 0.001), and HDL cholesterol/total cholesterol (r = 0.31, p < 0.001). Total (r = -0.20, p < 0.01) and free (r = -0.14, p < 0.05) testosterone were significantly inversely correlated with HDL cholesterol/total cholesterol ratio. Total testosterone concentrations were also significantly positively correlated with total cholesterol (r = 0.15), body mass index (r = 0.16), and systolic (r = 0.17) and diastolic (r = 0.18) blood pressures (all p < 0.01). DHEA-SO4 was not associated with any of the metabolic variables, while estrone was inversely associated only with the HDL cholesterol/total cholesterol ratio (r = 0.13, p < 0.05). The authors conclude that increased androgenization in postmenopausal women is associated with atherogenic changes in cardiovascular risk factors.
性激素在决定心血管疾病风险方面起着主要作用。虽然多项研究表明，绝经前女性性激素结合球蛋白降低与致动脉粥样硬化脂蛋白模式及血糖浓度升高有关，但关于绝经后女性（心血管疾病高发群体）性激素结合球蛋白和性激素与心血管危险因素之间关联的数据却很少。研究人员推测，在绝经后女性中，性激素结合球蛋白降低和睾酮升高与心血管危险因素的致动脉粥样硬化模式有关。在一项基于人群的研究——比弗迪姆眼研究（1988 - 1990年，威斯康星州比弗迪姆）中，对253名未服用激素的绝经后女性的性激素结合球蛋白、总睾酮和游离睾酮、雌酮以及硫酸脱氢表雄酮（DHEA - SO4）进行了测量。性激素结合球蛋白与体重指数显著负相关（r = - 0.53，p < 0.001）、糖化血红蛋白（r = - 0.34，p < 0.001）和舒张压（r = - 0.25，p < 0.001），与高密度脂蛋白胆固醇（HDL胆固醇）显著正相关（r = 0.31，p < 0.001）以及HDL胆固醇/总胆固醇（r = 0.31，p < 0.001）。总睾酮（r = - 0.20，p < 0.01）和游离睾酮（r = - 0.14，p < 0.05）与HDL胆固醇/总胆固醇比值显著负相关。总睾酮浓度也与总胆固醇（r = 0.15）、体重指数（r = 0.16）以及收缩压（r = 0.17）和舒张压（r = 0.18）显著正相关（均p < 0.01）。DHEA - SO4与任何代谢变量均无关联，而雌酮仅与HDL胆固醇/总胆固醇比值呈负相关（r = 0.13，p < 0.05）。作者得出结论，绝经后女性雄激素化增加与心血管危险因素的致动脉粥样硬化变化有关。
