绝经后荷尔蒙对炎症敏感蛋白质的影响:绝经后雌激素/孕激素干预 (PEPI) 研究
M Cushman1, C Legault, E Barrett-Connor
1Departments of Medicine, and Biochemistry, University of Vermont, Burlington, VT 05446, USA. mcushman@salus.uvm.edu
Circulation
|August 18, 1999
概括
绝经后的激素治疗显著增加了炎症标记物C反应蛋白,同时减少了可溶性E-selectin. 这些荷尔蒙对炎症因子的影响需要进一步调查心血管事件风险.
科学领域:
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 炎症研究 炎症研究
背景情况:
- 观察性研究表明,绝经后的激素治疗 (HT) 可以减少健康女性的冠心病事件.
- 然而,一项临床试验子组分析表明,对于已有冠状动脉疾病的女性,HT早期心血管风险增加.
- 炎症因素是已知的血管疾病预测因素,使其对HT的反应成为一个关键的研究领域.
研究的目的:
- 研究绝经后激素治疗对特定炎症敏感因素的影响.
- 为了确定不同的激素制剂是否对这些标记物有不同的影响.
- 评估激素治疗对与炎症有关的心血管疾病风险因素的持续影响.
主要方法:
- 这项研究分析了365名绝经后雌激素/孕激素干预 (PEPI) 试验的参与者的数据,这是一个随机的,安慰剂控制的研究.
- 在基线,12个月和36个月测量了四种炎症敏感因素 (C-反应蛋白,可溶性E-选择蛋白,·维莱布兰德因子抗原,因子VIIIc).
- 参与者接受了安慰剂或四种激素制剂中的一种.
主要成果:
- 与安慰剂相比,所有测试的激素制剂都显著增加了85%的C反应蛋白 (CRP) 度.
- 与安慰剂相比,可溶性E-选择因 (sE-选择因) 度下降了18%.
- 没有观察到对·维勒布兰德因子或因子VIIIc水平的显著影响,并且在活性治疗臂之间没有发现差异.
结论:
- 绝经后的荷尔蒙迅速提升C-反应性蛋白,一种促炎性标记物,可能解释早期的不良心血管影响.
- 激素治疗通过降低可溶性E-选择素水平,显示出抗炎作用.
- 需要进一步的研究来将这些激素诱导的炎症变化与临床心血管事件风险联系起来,因为PEPI试验不是为了临床终点评估而设计的.
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