老年妇女的激素水平会改变CVD风险
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By LabMedica International staff writers Posted on 28 Jun 2018 |
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图片：绝经妇女的睾丸酮/雌二醇比率与心血管病、冠心病和心力衰竭(HF)的风险（图片蒙约翰霍普金斯大学惠赐）。
雄激素水平升高、雌激素水平降低与妇女的心血管疾病(CVD)风险有关；然而，研究妇女的性激素与CVD发病事件后，却产生了相互矛盾的结果。
此前的研究显示，妇女绝经前的心脏病发病率低于男子，因为绝经后雌激素水平急剧下降，所以医师一度以为取代雌激素会降低心血管疾病风险。此前其它的研究显示雌激素替代品未必有保护作用，还可能升高脑卒中、凝血和心脏病风险。
一组科学家与美国马里兰州巴尔的摩的约翰霍普金斯大学医学院(www.hopkinsmedicine.org)合作，分析了2,834名绝经妇女的数据，她们参与了联邦资助的多民族动脉粥样硬化研究(MESA)项目。研究开始时参与者的平均年龄为65岁，38%是白人，28%是非裔，22%是拉丁裔，12%是华裔。初诊是在2000年到2002年期间，科学家取血样测量睾丸酮与雌激素的水平。
在12年的随访过程中，通过病历、住院、电话采访和死亡证书发现，这些妇女有283例心血管疾病，包括171例冠心病和心脏病突发、88例脑卒中和103例心力衰竭。科研小组比较心脏病与心血管疾病病例的睾丸酮与雌激素水平时发现，睾丸酮水平升高一般与风险升高相关，雌二醇水平升高一般与风险降低相关。睾丸酮与雌激素的比率每升高一个标准单位，心血管疾病风险就增加19%，冠心病风险增加45%，心力衰竭风险增加31%。
该研究的论文发表于2018年6月号的《美国心脏学会杂志》(of the American College of Cardiology)。资深作者、医学副教授Erin D. Michos大夫说：“医生不常检查女性的性激素水平及其比率。因为睾丸酮（主要的雄性激素）相对于雌二醇（主要的雌性激素）的比例不平衡，这可能影响心脏病风险，所以医生也许应考虑把激素检验作为一项可筛查的风险因子，补充其它风险因子，如血压和胆固醇，以识别心脏病或血管病风险更高的妇女。”
约翰霍普金斯大学医学院>>> www.hopkinsmedicine.org
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