更年期荷尔蒙治疗的长期认知影响:KEEPS延续研究的发现
Carey E Gleason1,2, N Maritza Dowling3, Firat Kara4
1Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America.
PLoS medicine
|November 21, 2024
概括
在更年期早期开始的更年期激素治疗 (mHT) 在一项为期10年的随访研究中没有显示出长期的认知益处或危害. 这些发现表明mHT在健康的绝经后妇女中是神经认知安全的,但不会增强认知功能.
科学领域:
- 神经科学是一个神经科学.
- 内分泌学 在内分泌学.
- 老年学是一门学科.
背景情况:
- 克罗诺斯早期雌激素预防研究 (KEEPS) -Cog试验在48个月后没有发现更年期激素治疗 (mHT) 的认知益处或危害.
- 为了评估长期影响,KEEPS延续研究在初始试验后大约10年重新评估了认知能力.
- 通过皮质雌激醇 (tE2) 的假设认知益处与口服结合性马类雌激素 (oCEE) 和安慰剂进行了比较.
研究的目的:
- 为了澄清在更年期后早期开始的mHT的长期认知,情绪和神经成像效应.
- 为了确定早期的mHT暴露是否会影响十年的认知轨迹.
- 为健康的绝经后妇女提供关于mHT神经认知安全性的保证.
主要方法:
- 对KEEPS参与者 (N=299) 的观察性纵向队列研究 (N=299) 在试验后10年重新接触.
- 参与者重复KEEPS-Cog认知测试电池;使用潜伏生长模型 (LGM) 分析数据.
- LGMs评估了基线认知和KEEPS期间的变化,预测后续表现和mHT效应.
主要成果:
- 与安慰剂相比,没有观察到mHT (oCEE或tE2) 与安慰剂的统计学上显著的长期认知影响.
- 在KEEPS试验期间的基线认知和认知变化是以后认知表现的最强预测因素.
- 横截面比较显示,mHT和安慰剂组之间的认知表现在治疗后10年左右是相似的.
结论:
- 与安慰剂相比,在更年期早期开始的短期mHT没有明显的长期认知影响.
- 数据表明,mHT对健康的,最近绝经后的女性来说是神经认知安全的.
- 在这个人群中,mHT似乎没有改善或保持认知功能.
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