男性CHD患者血清性激素、Hcy、hs-CRP和ET水平的关系

目的：为了进行男性冠心病（chronary heart disease,CHD）患者与血清性激素、Hcy、hs-CRP和ET水平关系。方法：发光免疫分析了96例男性CHD患者和68例正常对照组血清性激素和Hcy,放射免疫分析了血清hs-CRP和ET。结果：96例男性CHD患者血清性激素较之68例正常对照组,E2明显增高（P〈0.01）,T明显降低（P〈0.01）,而血清Hcy、hs-CRP和ET均明显增高（P〈0.05～P〈0.01）。结论：男性CHD患者的发生发展与血清性激素、Hcy、hs-CRP和ET水平密切相关。     

阿尔茨海默病患者血清同型半胱氨酸水平变化

目的:分析同型半胱氨酸(Hcy)在不同阶段阿尔茨海默病(AD)患者中的水平变化和临床价值。方法:根据相关标准将AD患者分为无症状临床前AD阶段组、AD前有症状阶段组和AD阶段组。采用酶法检测以上三个阶段AD患者及同龄正常对照组血清Hcy水平,比较组间检测结果及各组异常率的统计学差异。结果:三组AD患者血清Hcy水平均高于对照组(P<0.05);AD阶段组和AD前有症状阶段组Hcy水平高于无症状临床前AD阶段组(P<0.05);AD阶段组血清Hcy水平高于AD前有症状阶段组(P<0.05);AD前有症状阶段组和AD阶段组的Hcy水平异常率高于无症状临床前AD阶段组(P<0.05);Hcy水平和不同程度AD呈正相关(P<0.05);不同程度AD与Hcy水平异常率呈正相关(P<0.05)。结论:血清Hcy水平与AD有关。     

糖尿病合并亚临床甲减同型半胱氨酸与超敏C-反应蛋白水平的变化及意义

目的 探讨糖尿病合并亚临床甲状腺功能减退(subclinical hypothyroidism,SCH)患者血同型半胱氨酸和超敏C-反应蛋白水平变化及意义.方法 将糖尿病合并亚临床甲减患者60例与同期入院糖尿病伴甲状腺功能正常患者120例作为研究对象,比较两组血同型半胱氨酸与超敏C-反应蛋白的变化.结果 糖尿病合并亚临床甲减同型半胱氨酸与超敏C-反应蛋白水平均显著高于糖尿病伴甲状腺功能正常患者(P＜0.05).结论 血同型半胱氨酸和超敏C-反应蛋白水平可作为糖尿病合并亚临床甲减患者发生动脉粥样硬化及心血管疾病风险的预测指标之一.     

脑梗死患者血清同型半胱氨酸水平与临床意义

目的　探讨脑梗死患者血清中同型半胱氨酸 (Homocysteine ,Hcy)的变化与临床意义 .方法　用全自动化学免疫发光法对本院已确诊脑梗死 5 0例血清Hcy进行了测定比较 .结果　脑梗死组血清Hcyx=2 3.5umol/L ,与正常组x=8.5umol/L(p <0 .0 1) .结论　脑梗死患者血清Hcy增高 ,为临床诊断、治疗、愈后观察提供有意义参考数据 .     

脑梗死患者血清同型半胱氨酸水平与临床意义

目的探讨脑梗死患者血清中同型半胱氨酸(Homocysteine,Hcy)的变化与临床意义.方法用全自动化学免疫发光法对本院已确诊脑梗死50例血清Hcy进行了测定比较.结果脑梗死组血清Hcy x=23.5umol/L,与正常组x=8.5umol/L(p<0.01).结论脑梗死患者血清Hcy增高,为临床诊断、治疗、愈后观察提供有意义参考数据.     

血清同型半胱氨酸、高敏C反应蛋白水平与心脑血管事件危险相关性分析

探讨血清同型半胱氨酸（Hcy）、超敏C反应蛋白（hs-CRP）升高对心脑血管硬化形成的影响和心脑血管事件危险的相关性。应用化学发光法和免疫比浊法对62名健康体检者和115例急性冠脉综合征（ACS）、脑卒中（ST）、脑梗死（CI）患者住院时血清Hcy和hs-CRP水平进行测定。结果表明ACS、ST、CI三组患者血清Hcy和hs-CRP水平与对照组相比具有显著性差异（P〈0.01）;且此两项指标升高和心脑血管事件呈正相关（P〈0.01）。血清Hcy和hs-CRP升高是心脑血管事件的危险因素且与它们发生发展密切相关。作为常规检测,血清Hcy和hs-CRP联合测定对心脑血管事件的预测、治疗和预防具有重要的临床价值。     

血清同型半胱氨酸和性激素水平与老年男性冠心病的相关性分析

目的:分析血清同型半胱氨酸(HCY)和性激素水平与老年男性冠心病(CHD)的关系。方法:收集对照组(n=34)及冠心病患者(n=72)血标本,测定血清HCY、雌二醇(E2)、孕酮(P)、睾酮(T)和血脂水平,并对各指标与CHD进行相关分析。结果:CHD组HCY及E2/T水平显著高于对照组,T水平显著低于对照组,多元线性逐步回归分析显示,HCY、T及总胆固醇(TC)与CHD相关(标准化偏回归系数分别为0.4657,-0.3452,0.2016,P<0.05),其中HCY的影响更为明显。HCY与E2/T显著正相关。结论:HCY水平升高及性激素功能紊乱与老年男性CHD相关。     

幽门螺杆菌感染对冠心病患者血清同型半胱氨酸水平的影响

目的探讨幽门螺杆菌(Hp)对冠心病患者同型半胱氨酸水平的影响,了解Hp感染与冠心病发生之间可能的关系。方法60例经冠状动脉造影确诊为冠心病的患者分为实验组(Hp阳性40例),对照组(Hp阴性20例),实验组行Hp根治。14C呼气试验检测幽门螺杆菌感染,生化仪检测血清同型半胱氨酸,颈部血管超声检查颈动脉内膜中层厚度(IMT)。结果实验组血清同型半胱氨酸和颈动脉内膜中层厚度均高于对照组(<0.05);Hp根治后实验组血清同型半胱氨酸和颈动脉内膜中层厚度明显好转,与对照组无显著差异(>0.05)。结论 Hp感染能够通过增加同型半胱氨酸水平来影响冠心病的发生和发展。     

同型半胱氨酸、同型半胱氨酸诱导基因抗体及叶酸对人胚心肌细胞同型半胱氨酸诱导基因的表达及细胞增殖的影响

目的：研究同型半胱氨酸(HCY)、同型半胱氨酸诱导基因抗体(HCY-2Ab)及叶酸对人胚心肌细胞HCY-2表达及对心肌细胞增殖的影响。方法：采用免疫细胞化学、RT-PCR法体外测定人胚心肌细胞内HCY-2表达;用细胞计数法和MTT法对心肌细胞增殖的变化定量分析。结果：当HCY的浓度小于1.25mmol／L时,HCY-2的表达随着HCY浓度的增高而逐渐增强,HCY促进细胞的增殖;当HCY浓度超过1.25mmol／L时,则HCY-2的表达逐渐降低,HCY抑制细胞的增殖;加入HCY-2Ab或叶酸,HCY-2的表达减弱,同时抑制细胞的增殖。结论：HCY-2高表达时HCY对心肌细胞的增殖起促进作用;HCY-2低表达时则HCY、HCY-2Ab或叶酸抑制心肌细胞的增殖。     

阿尔茨海默病与血浆同型半胱氨酸水平的相关性

目的探讨血浆同型半胱氨酸(Hcy)水平与阿尔茨海默病(AD)的相关性。方法检测100例AD患者与30例正常老年人血浆Hcy浓度,采用简易精神状况量表(MMSE)对两组进行认知功能评定并与血浆Hcy浓度进行相关性研究。结果AD组血浆Hcy浓度高于正常对照组,有非常显著性差异(t=6.74,P0.01);AD组MMSE评分与血浆Hcy浓度呈负相关(r=-0.79,P0.01)。结论高Hcy血症可能是AD危险因素,该研究为AD早期干预提供了依据。     

Ultra low-dose hormone replacement therapy and bone protection in postmenopausal women

OBJECTIVES: The aim of the present study was to evaluate the effects of low doses of hormone replacement therapy (HRT) in normal young postmenopausal women. METHODS: In an open trial healthy, non-obese postmenopausal women received for 2 years a low-dose continuous combined HRT (LD-HRT) containing 1mg estradiol+0.5 mg norethisterone acetate each pill for 28 days, or 0.5 mg of 17beta-estradiol and 0.25 mg of norethisterone acetate (Ultra low dose, Ultra-LD-HRT) along with 1000 mg of calcium per day. Control group consisted of women receiving only 1000 mg of calcium per day, for 2 years. Menopausal symptoms were evaluated by the Green climacteric scale for the first 12 weeks of the study while bleeding profiles, bone mineral density (BMD) and bone turnover were assessed for 24 months. RESULTS: LD-HRT and Ultra-LD-HRT were effective in reducing menopausal clinical symptoms. In the control group, BMD significantly (P<0.05) decreased at the spine (-2.8+/-0.2%), and femoral neck (-2.8+/-0.7%). In LD-HRT treated group BMD showed a significant (P<0.05) increase at the spine (5.2+/-0.7%), and femoral neck (2.8+/-0.4%) after 24 months. In the Ultra-LD-HRT treated women spine and femoral neck BMD showed a significant (P<0.05) increase (2.0+/-0.3 and 1.8+/-0.3%, respectively) after 24 months. In these women treated with LD-HRT and Ultra-LD-HRT the BMD values were significantly (P<0.05) different from those measured in calcium-treated women. CONCLUSIONS: LD-HRT and Ultra-LD-HRT can alleviate subjective symptoms providing an effective protection against the postmenopausal decrease of BMD.     

Attitudes towards and level of information on perimenopausal and postmenopausal hormone replacement therapy among Norwegian women

In order to investigate women's attitudes towards and level of information on perimenopausal and postmenopausal hormone replacement therapy (HRT) 1019 women over 17 years of age constituting a representative sample of the Norwegian female population were interviewed in 1990 as part of a monthly national opinion poll (response rate 96.5%). Women's magazines proved to be the most important source of information on hormone therapy. Only in the over-45 age group were doctors mentioned frequently as information sources. A high self-assessed information level was associated with a positive attitude towards hormone therapy. Those who had obtained information from a doctor were more positive than those who had not. More than half of those who expressed an opinion believed that hormone therapy increased the risk of heart infarction, stroke, breast cancer and cancer in general. There was a strong association between a negative attitude, towards using hormones and belief in an increased risk of serious disease. The women were more positive towards the use of HRT for the prevention of osteoporosis and for postmenopausal urogenital complaints than for the alleviation of climacteric symptoms.     

Cytohormonal and morphological alterations in cervicovaginal smears of postmenopausal women on hormone replacement therapy

The objective of the study was to study the cytohormonal and morphological alterations in cervicovaginal smears associated with the use of hormone replacement therapy (HRT) and to assess the utility of vaginal cytology in determining the response to HRT. Ninety postmenopausal women (30 on estrogen-progesterone combination (HRT) for 1 to 24 mo (user 1), 30 on estrogen therapy (ERT) for 1 to 44 mo (user 2), and 30 not on any hormones (nonusers)) were included in the cross-sectional study. Their lateral vaginal wall smears and cervical smears were examined for hormonal and morphological assessments, respectively. The smear pattern showed predominance of parabasal cells in 46.6% of nonusers, while none of the users had >70% parabasal cells. A high percentage (>70%) of intermediate cells was found in 46.6% of users and only in 16.6% of nonusers. A high maturation value (MV) was found in more than 75% of users but in only 16.6% of nonusers. The women with high MV (>50) were significantly less symptomatic than did nonusers. Atrophic changes were present in cervical smears of 14/20 (46.6%) nonusers when compared with 1/60 (1.66%) users. Atypical squamous cells of undetermined significance (ASC-US) were diagnosed in seven users and three nonusers. It persisted on follow-up in four users and one nonuser. Histology revealed one mild dysplasia among users. Lactobacilli were more frequently observed in users. The cytohormonal pattern on vaginal smears correlates well with the response to hormonal therapy and clinical symptoms. Awareness of the morphological alterations associated with the use of replacement hormones would enable the cytologists to reduce the false-positive diagnoses while evaluating postmenopausal smears.     

Hormone replacement therapy, C-reactive protein, and fibrinogen in healthy postmenopausal women

Objective: To investigate short-term and long-term effects of combined hormone replacement therapy (HRT) on C-reactive protein (CRP) and fibrinogen plasma concentrations in healthy postmenopausal women. Methods: In this cross-sectional study 241 healthy postmenopausal women were enrolled. A total of 81 women were receiving the following treatments for 3 months; transdermal 17β-estradiol (17β-E₂)+medroxyprogesterone acetate (MPA) (n=21), oral 17β-E₂+norethisterone acetate (NETA) (n=27), and conjugated equine estrogens (CEE)+MPA (n=33). The same combined therapies were implemented in another 58 women for 12 months; transdermal 17β-E₂+MPA (n=10), oral 17β-E₂+NETA (n=16), and CEE+MPA (n=32). Control group included 102 healthy postmenopausal women not receiving HRT. The effect of the type and the duration of HRT regimens on plasma levels of CRP, fibrinogen and lipids were investigated. Results: Median CRP concentrations were significantly higher in women receiving oral 17β-E₂+NETA (P=0.037) and CEE+MPA (P=0.0001) for 3 months than in women taking the same types of HRT for 12 months and of those were not on HRT. Median CRP levels were similar in women taking transdermal 17β-E₂+MPA for 3 and 12 months, compared with controls. Fibrinogen levels were not different between nonusers and any group of HRT users. Conclusions: These elevated levels of CRP, which appears very recently as a crucial marker for cardiovascular disease, may be responsible for the early increased cardiovascular risk after starting oral combined HRT. But this increased risk in the early period seems to decrease with long-term use. Transdermal 17β-E₂+MPA had insignificant effect on CRP both in short-term or in long-term use.     

Influence of hormone replacement therapy on proteomic pattern in serum of postmenopausal women

OBJECTIVES: Proteomics approaches to cardiovascular biology and disease hold the promise of identifying specific proteins and peptides or modification thereof to assist in the identification of novel biomarkers. METHOD: By using surface-enhanced laser desorption and ionization time of flight mass spectroscopy (SELDI-TOF-MS) serum peptide and protein patterns were detected enabling to discriminate between postmenopausal women with and without hormone replacement therapy (HRT). RESULTS: Serum of 13 HRT and 27 control subjects was analyzed and 42 peptides and proteins could be tentatively identified based on their molecular weight and binding characteristics on the chip surface. By using decision tree-based Biomarker Patternstrade mark Software classification and regression analysis a discriminatory function was developed allowing to distinguish between HRT women and controls correctly and, thus, yielding a sensitivity of 100% and a specificity of 100%. The results show that peptide and protein patterns have the potential to deliver novel biomarkers as well as pinpointing targets for improved treatment. The biomarkers obtained represent a promising tool to discriminate between HRT users and non-users. CONCLUSION: According to a tentative identification of the markers by their molecular weight and binding characteristics, most of them appear to be part of the inflammation induced acute-phase response.     

Effects of hormone replacement therapy on growth hormone secretion patterns in correlation to somatometric parameters in healthy postmenopausal women

Objectives: The aim of the present study was to investigate the influence of a continous estrogen, cyclic progesterone replacement therapy on the secretion of growth hormone (GH) and IGF I as well as of somatometric-GH correlation patterns. Methods: The study included 23 healthy postmenopausal women. Of the proband group 13 randomly selected women were treated with orally applicated 2 mg estradiol-valerat (E2V) and 10 mg dydrogesterone for 10 months. Ten women did not receive any hormonal treatment during this time. After 10 months all probands were reexamined and their GH and IGF I secretion, as well as their somatometric-hormonal correlation patterns, compared with those of a fertile control group. Results: It could be shown, that in postmenopausal women a 10-month oral hormone replacement therapy led to a significant increase of GH- and IGF I levels, however, the treated postmenopausal women did not reach the levels of the fertile controls. Those women who did not receive any hormonal treatment and the postmenopausal women before HRT showed nearly identical GH- and IGF I levels as well as somatometric-GH correlation patterns. Conclusions: The results of the present paper indicate a marked influence of estrogens on GH and IGF I secretion. Furthermore, hormonal replacement therapy (HRT) may influence somatometric GH correlation patterns too.     

Effects of raloxifene and hormone replacement therapy on forearm skin elasticity in postmenopausal women

Objectives

Hormone replacement therapy (HRT) increases skin elasticity in postmenopausal women. However, the effects of raloxifene, a selective estrogen receptor modulator (SERM), on skin degenerative changes in postmenopausal women remain unknown. We investigated whether raloxifene increases skin elasticity, similar to HRT, in postmenopausal women.

Methods

In a 12-month trial, 17 postmenopausal women (mean age, 66.4 ± 7.8 years) received continuous raloxifene treatment (60 mg/day), 19 women (56.2 ± 6.4 years) received continuous 17-β estradiol treatment using a patch (0.72 mg/2 days) plus cyclic medroxyprogesterone acetate (2.5 mg/day, for 12 days/month), and 11 women (58.1 ± 7.3 years) did not receive either therapy. In each subject, the skin elasticity of the forearm was measured using a suction device at baseline and at 12 months after the start of the study.

Results

Raloxifene and HRT significantly increased skin elasticity from 52.4 ± 3.8% and 64.1 ± 7.2% at baseline to 55.1 ± 4.7% and 67.4 ± 7.4% after 12 months, respectively (P < 0.05, each), but the untreated subjects did not exhibit any significant change in skin elasticity during the study. The delta value for skin elasticity was significantly higher among the raloxifene and HRT subjects than among the untreated subjects (P < 0.05, each).

Conclusions

These findings suggest that raloxifene may have a beneficial effect on skin elasticity, which undergoes degenerative changes in postmenopausal women, in addition to its effects on bone metabolism.     

Endometrial cytology in postmenopausal hormone replacement therapy

Endometrial changes in postmenopausal hormone replacement therapy (HRT) were studied by comparing cytological and histological findings. Cytological and histological examinations were conducted on 138 benign cases and 26 abnormal cases, including 24 cases with disordered proliferative phase (DOP) and 2 cases with simple endometrial hyperplasia (SEH), for a total of 164 cases. Hormones were administered as follows: 1) single cyclic administration of estrogen only (Single-HRT) for 31 cases, 2) cyclic administration of estrogen and progestin (Cyclic-HRT) for 105 cases, and 3) continuous administration of estrogen and progestin (Continuous-HRT) for 28 cases. All of the 164 cases were studied cytologically as to shape, appearance, nuclear number on maximum diameter, and so on. The benign cases in each mode of administration as described above revealed the following: 1) Single-HRT, atrophy or the proliferative phase was noted histologically, and the copresence of the endometrial epithelium and the ciliated cell metaplasia was observed cytologically; 2) Cyclic-HRT, the first half of the administration term was of the proliferative phase histologically, and the linear and long glands were seen cytologically. In the latter half of the administration term the secretory phase was noted histologically and the curved/linear glands with subnuclear vacuolization were observed cytologically; and 3) Continuous-HRT, atrophy was noted histologically, and fewer glands and atrophic cells on the endometrial epithelium with wrinkles mixed therein were seen cytologically. On the other hand, cytological examinations of the abnormal cases revealed a mean average of 35 nuclei on the maximum diameter of the gland, protrusion and/or ramification of the glands, densely clustered glands, and back-to-back glands without fusion, as well as irregularly dilated tortuous glands in SEH. These abnormal findings were considered useful for early detection of endometrial disorders in the hormone replacement therapy by cytodiagnosis. Diagn. Cytopathol. 1998;19:161–167. © 1998 Wiley-Liss, Inc.     

Effects of alendronate and hormone replacement therapy, alone or in combination, on bone mass in postmenopausal women with osteoporosis: a prospective, randomized study

The effectiveness of hormone replacement therapy (HRT) and alendronate, alone and in combination, was evaluated in 120 postmenopausal patients with osteoporosis with bone mineral density (BMD) measurements at least 2 SD below the mean value for young premenopausal subjects. They had no contra-indications to HRT or alendronate use and were randomized to three different treatment groups. Group I was treated with micronized 17 beta-oestradiol 2 mg and norethisterone acetate 1 mg/day per os, group II received alendronate 10 mg/day per os and group III received micronized 17 beta-oestradiol 2 mg, norethisterone acetate 1 mg/day per os and alendronate 10 mg/day per os for 1 year. Elementary calcium 1500 mg/day was supplied to patients in all three groups. Spinal and femoral neck BMD and markers of bone mineral metabolism were measured on each patient before treatment and 6 and 12 months after treatment in 95 patients. At the end of the 12th month, significant increases in spinal and femoral neck BMD were found in all groups. Increases in spinal BMD were significantly higher in patients treated with alendronate and alendronate with HRT when compared with patients treated with HRT only. No significant difference was found in femoral neck BMD changes between the groups. Significant decreases in bone resorption and markers of bone formation were observed in all groups. Alendronate was found to be more effective than HRT and could have a very beneficial effect when added to the HRT regimen in patients with postmenopausal osteoporosis. Alendronate might also be used in postmenopausal patients with osteoporosis when HRT is contra-indicated or when there is reluctance to use hormonal treatment.     

Effect of long-term hormone therapy on telomere length in postmenopausal women

Telomeres undergo attrition with each cell division, and telomere length is associated with age-related diseases and mortality in the elderly. Estrogen can influence the attrition of telomeres by diverse mechanisms. This is a retrospective case control study that investigated the influence of long-term hormone therapy (HT) on telomere length in postmenopausal women. We recruited 130 postmenopausal women from 55 to 69 years of age for this study, and divided them into two groups. The first group included 65 women who had been on estrogen and progesterone therapy for more than five years (HT group). The other group was composed of 65 women matched in age to the HT group who had never had HT (non- HT group). The relative ratios of telomere length of study subjects to a reference DNA from a healthy young female were measured using quantitative PCR. Plasma levels of lipid profiles, total antioxidant status (TAS), C-reactive proteins (CRP), fasting glucose levels, and estradiol levels were measured. Age at menopause, vitamin use, and exercise, alcohol, and cigarette smoking histories were also assessed in a questionnaire. Mean duration (+/- SD) of HT was 8.4 +/- 2.3 years. Prevalence of vitamin use and regular exercise were higher in the HT group than in the non-HT group (p < 0.01). Relative telomere length ratios in the HT group were significantly greater than those in the non-HT group (p < 0.01). HT was significantly correlated with the relative telomere length ratio in multivariate analysis when potential confounding variables were controlled for (p < 0.05). In conclusion, telomere lengths were longer in postmenopausal women who had a history of long-term HT than in postmenopausal women without HT. Long-term HT in postmenopausal women may alleviate telomere attrition.