Wilcox J G, Hatch I E, Gentzschein E, Stanczyk F Z, Lobo R A
Department of Obstetrics and Gynecology, University of Southern California School of Medicine, Los Angeles, USA.
Fertil Steril. 1997 Feb;67(2):273-7. doi: 10.1016/S0015-0282(97)81910-3.
To establish levels of plasma endothelin-1 in postmenopausal women with increased CV risk as compared with healthy premenopausal women and to measure the effects of different forms of estrogen replacement on plasma endothelin-1.
Prospective randomized study.
University of Southern California Medical Center.
PATIENT(S): We studied 18 postmenopausal women (mean age 53.4 +/- 4.9 years) with total cholesterol levels > 240 mg/dL divided into those with and without hypertension as well as in 10 healthy premenopausal women.
INTERVENTION(S): The postmenopausal women were randomized to receive oral estrone sulfate, transdermal E2, or placebo for 30 days.
MAIN OUTCOME MEASURE(S): We measured the endothelin-1 levels and total cholesterol at baseline and after 30 days of estrogen treatment.
RESULT(S): In the postmenopausal women, endothelin-1 was higher (4.58 +/- 0.46 pg/mL) compared with premenopausal levels (2.80 +/- 0.46 pg/mL). In hypertensive postmenopausal women, endothelin-1 was 5.56 +/- 0.44 pg/mL. After estrogen, plasma endothelin-1 values decreased from 5.38 +/- 0.66 to 4.82 +/- 0.9 pg/mL with oral estrone sulfate, 4.84 +/- 0.25 to 4.54 +/- 0.49 pg/mL with transdermal E2, and did not change after placebo 4.76 +/- 0.71 to 4.81 +/- 0.46 pg/mL. In evaluating hypertensive women alone with estrogen therapy, plasma endothelin-1 showed the greatest decrement from 5.39 +/- 0.49 to 4.4 +/- 0.59 pg/mL (18.4%). The decrease in endothelin-1 with estrogen, which was statistically significant for the entire group, did appear to be influenced by the route of administration. Baseline plasma endothelin-1 levels were correlated positively to plasma cholesterol levels with a correlation coefficient of 0.632.
CONCLUSION(S): These data provide another potential mechanism explaining the cardioprotective effects of hormone replacement therapy.
与健康的绝经前女性相比，确定心血管疾病风险增加的绝经后女性血浆内皮素-1水平，并测定不同形式雌激素替代疗法对血浆内皮素-1的影响。
前瞻性随机研究。
南加州大学医学中心。
我们研究了18名绝经后女性（平均年龄53.4±4.9岁），其总胆固醇水平>240mg/dL，分为有高血压和无高血压两组，以及10名健康的绝经前女性。
绝经后女性被随机分为接受口服硫酸雌酮、经皮雌二醇或安慰剂治疗30天。
我们在基线和雌激素治疗30天后测量内皮素-1水平和总胆固醇。
绝经后女性的内皮素-1水平（4.58±0.46pg/mL）高于绝经前水平（2.80±0.46pg/mL）。高血压绝经后女性的内皮素-1水平为5.56±0.44pg/mL。雌激素治疗后，口服硫酸雌酮使血浆内皮素-1值从5.38±0.66降至4.82±0.9pg/mL，经皮雌二醇使其从4.84±0.25降至4.54±0.49pg/mL，安慰剂组则未变化（从4.76±0.71降至4.81±0.46pg/mL）。单独评估接受雌激素治疗的高血压女性时，血浆内皮素-1降幅最大，从5.39±0.49降至4.4±0.59pg/mL（18.4%）。雌激素使内皮素-1降低，这在整个组中具有统计学意义，且似乎受给药途径的影响。基线血浆内皮素-1水平与血浆胆固醇水平呈正相关，相关系数为0.632。
这些数据提供了另一种潜在机制来解释激素替代疗法的心脏保护作用。
