Impact of oestrogens on the risk of acute myocardial infarction among postmenopausal women
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摘要: 目的:本研究探讨内源性雌激素水平对绝经后女性急性心肌梗死(AMI)发生的影响。方法:本研究共计纳入30例绝经后女性AMI患者(AMI组)和60例健康绝经后女性(对照组)。所有患者均检测内源性性激素水平(包括血雌酮、雌二醇、雄烯二醇和睾酮水平)。多因素Logistic 回归分析性激素水平与AMI发生风险的关系。结果:与对照组相比,AMI组的血雌酮、雌二醇、雄烯二醇和睾酮水平明显升高 (P<0.05),而性激素结合球蛋白(SHBG)水平却减低 (P<0.05)。单因素Logistic回归分析显示,雌酮、雌二醇、睾酮、臀腰比、体质指数、糖尿病和高血压均与AMI发生呈正相关 (P<0.05)。校正这些因素后,雌二醇[比值比(OR) 4.75,95% 可信区间(CI) :1.07~21.10,P<0.05]和腰臀比(OR=6.46,95%CI:1.09~38.39,P<0.05)仍和AMI呈正相关。结论:高雌二醇水平与绝经后女性AMI的发生呈正相关,提示内源性高雌激素可能是绝经后女性AMI发生的独立危险因素。Abstract: Objective:To investigate the correlation between endogenous oestrogens and acute myocardial infarction (AMI) risk among postmenopausal women.Method:A case-control study was performed among 30 AMI patients among postmenopausal women and 60 control subjects. The serum levels of endogenous sex hormones levels were detected.Conditional Logistic regression models were developed with adjustment for confounders.Result:Compared with controls, the circulating oestrone, oestradiol, androstenedione and testosterone levels were significantly higher in AMI patients (P<0.05) while the sex hormone binding globulin (SHBG) level was lower (P<0.05). In univariable Logistic regression models, oestrone, oestradiol, testosterone, WHR, BMI, diabetes and hypertension were all found to be positively associated with AMI (P<0.05). After adjusting for these factors, oestradiol [odds ratio (OR)=4.75,95%confidence interval (CI):1.07~21.10,P<0.05] and WHR (OR=6.46,95% CI:1.09~38.39,P<0.05) continued to demonstrate strong positive associations with AMI. Conclusion:A higher level of oestradiol is potentially associated with AMI risk among postmenopausal women.
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Key words:
- oestrogens /
- acute myocardial infarction /
- acute stress /
- adipose tissue /
- postmenopausal women
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[1] SIVASINPRASASN S,SHINLAOAWITTAYATORN K,CHATTIPAKORN S C,et al.Estrogenic Impact on Cardiac Ischemic/Reperfusion Injury[J].J Cardiovasc Transl Res,2016,9:23-39.
[2] MAAS A H,APPELMAN Y E.Gender differences in coronary heart disease[J].Neth Heart J,2010,18:598-603.
[3] WHAYNE T F JR,MUKHERJEE D.Women,the menopause,hormone replacement therapy and coronary heart disease[J].Curr Opin Cardiol,2015,30:432-438.
[4] CHEN Y,ZELENIUCH-JACQUOTTE A,ARSLAN A A,et al.Endogenous hormones and coronary heart disease in postmenopausal women[J].Atherosclerosis,2011,216:414-419.
[5] CREATSA M,ARMENI E,STAMATELOPOULOS K,et al.Circulating androgen levels are associated with subclinical athersclerosis and arterial stiffness in healthy recently menopausal women[J].Metabolism,2012,61:193-201.
[6] HOU N,HONG S,WANG W,et al.Hormone replacement therapy and breast cancer:heterogeneous risks by race,weight,and breast density[J].J Natl Cancer Inst,2013,105:1365-1372.
[7] SIDAWAY P.Risk factors:HRT increases risk of ovarian cancer[J].Nat Rev Clin Oncol,2015,12:251.
[8] PRENTICE R L,LANGER R D,STEFANICK M L,et al.Combined analysis of Women's Health Initiative observational and clinical trial data on postmenopausal hormone treatment and cardiovascular disease[J].Am J Epidemiol,2006,163:589.
[9] LIU H,PEDRAM A,KIN J K.Oestrogen prevents cardiomyocyte apoptosis by suppressing p38 alpha-mediated activation of p53 and by down-regulating p53 inhibition on p38 beta[J].Cardiovasc Res,2011,89:119-128.
[10] PEDRAM A,RAZANDI M,O'MAHONY F,et al.Estrogen receptor-beta prevents cardiac fibrosis[J].Mol Endocrinol,2010,24:2152-2165.
[11] KHALIL R A.Estrogen,vascular estrogen receptor and hormone therapy in postmenopausal vascular disease[J].Biochem Pharmacol,2013,86:1627-1642.
[12] MCCARTHY A M,MENKE A,OUYANG P,et al.Bilateral oophorectomy,body mass index,and mortality in U.S.women aged 40years and older[J].Cancer Prev Res(Phlia),2012,5:847-854.
[13] 吴小立,韩自力,钟智勇,等.围绝经期女性情绪障碍影响因素的综合探讨[J].中国病理生理杂志,2011,27(3):599-602.
[14] BREEN K M,KARSCH F J.Does cortisol inhibit pulsatile luteinizing hormone secretion at the hypothalamic or pituitary level?[J].Endocrinology,2004,145:692-698.
[15] BAQLIETTO L,ENGLISH D R,HOPPER J L,et al.Circulating steroid hormone concentrations in postmenopausal women in relation to body size and composition[J].Breast Cancer Res Treat,2009,115:171-179.
[16] FREEMAN W,SAMMEL D,LIN GARCIA R,et al.Obesity and reproductive hormone levels in the transition to menopause[J].Menopause,2010,17:718-726.
[17] PUROHIT A,NEWMAN S P,REED M J.The role of cytokines in regulating estrogen synthesis:implications for the etiology of breast cancer[J].Breast Cancer Res,2002,4:65-69.
[18] 张冬,窦克非.绝经期前女性冠心病发病机制研究进展[J].中国循环杂志,2012,27(5):397-398.
[19] ROSSOUW J E,ANDERSON G L,PRENTICE R L,et al.Risks and benefits of estrogen plus progestin in healthy postmenopausal women:principal results From the Women's Health Initiative randomized controlled trial[J].JAMA,2002,288:321-333.
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