Massoudi M S, Meilahn E N, Orchard T J, Foley T P, Kuller L H, Costantino J P, Buhari A M
Graduate School of Public Health, University of Pittsburgh, Pennsylvania, USA.
J Womens Health. 1997 Oct;6(5):553-8. doi: 10.1089/jwh.1997.6.553.
We designed a prospective observational trial to study the relationship of thyroid function to cholesterol and weight changes at menopause. Subjects were participants in the ongoing Healthy Women Study, a prospective study of cardiovascular risk factor change through menopause. Healthy premenopausal women were recruited from a random sample of licensed drivers in selected ZIP codes of Allegheny County, Pennsylvania. Participants had to be 42-50 years of age, have menstruated within the last 3 months, not have had surgical menopause, have diastolic blood pressure < 100 mm Hg, and not be taking medications (including insulin, estrogen, lipid-lowering drugs, or thyroid or antihypertensive medications) at the baseline examination. The substudy included three groups of women who were premenopausal at baseline and were categorized according to change noted at follow-up regarding menopausal status and use of hormone replacement therapy (HRT). The groups comprised 95 women who remained premenopausal, 96 postmenopausal women not on HRT, and 61 postmenopausal women using HRT. The main outcome measures were baseline and follow-up measurements for serum levels of thyroid-stimulating hormone (TSH), thyroid peroxidase, and thyroglobulin, as well as serum cholesterol, total high-density lipoprotein (HDL) cholesterol, triglycerides, and calculated low-density lipoprotein (LDL) cholesterol, height, and weight. Covariates included cigarette smoking and alcohol intake. The prevalence of thyroid antibodies in this healthy population was high at both time points (range 27%-31%) and did not differ by menopausal status. The presence of thyroid antibodies was associated with increased TSH concentration. Women with antibodies at both time points had lower levels of total and LDL cholesterol compared with those with no antibodies, significant only for those women who remained premenopausal during the follow-up period. Thyroid function during menopause in this healthy population is unlikely to account for the observed changes in levels of serum lipoprotein and body weight. The presence of thyroid antibodies may be associated with lower total and LDL cholesterol, possibly through an underlying inflammatory disorder.
我们设计了一项前瞻性观察性试验，以研究甲状腺功能与绝经时胆固醇及体重变化之间的关系。研究对象为正在进行的“健康女性研究”的参与者，该研究是一项关于绝经前后心血管危险因素变化的前瞻性研究。健康的绝经前女性是从宾夕法尼亚州阿勒格尼县选定邮政编码区域内的持照驾驶员随机样本中招募的。参与者年龄必须在42 - 50岁之间，在过去3个月内有月经，未经历手术绝经，舒张压<100 mmHg，且在基线检查时未服用药物（包括胰岛素、雌激素、降脂药物、甲状腺或抗高血压药物）。该子研究包括三组在基线时处于绝经前的女性，根据随访时绝经状态和激素替代疗法（HRT）使用情况的变化进行分类。这三组包括95名仍处于绝经前的女性、96名未使用HRT的绝经后女性和61名使用HRT的绝经后女性。主要观察指标为血清促甲状腺激素（TSH）、甲状腺过氧化物酶和甲状腺球蛋白水平，以及血清胆固醇、总高密度脂蛋白（HDL）胆固醇、甘油三酯和计算得出的低密度脂蛋白（LDL）胆固醇、身高和体重的基线及随访测量值。协变量包括吸烟和饮酒情况。在这两个时间点，该健康人群中甲状腺抗体的患病率都很高（范围为27% - 31%），且在绝经状态方面无差异。甲状腺抗体的存在与TSH浓度升高有关。在两个时间点都有抗体的女性与没有抗体的女性相比，总胆固醇和LDL胆固醇水平较低，仅在随访期间仍处于绝经前的女性中具有统计学意义。在这个健康人群中，绝经期间的甲状腺功能不太可能解释观察到的血清脂蛋白水平和体重变化。甲状腺抗体的存在可能与总胆固醇和LDL胆固醇水平较低有关，可能是通过潜在的炎症性疾病。
