Gender differences in the cardiovascular effects of sex hormones

Over the last decade, compelling evidence supports the idea that the different impact of cardiovascular disease (CVD) and the differences in vascular biology in men and women may be, at least in part, related to the cardiovascular and metabolic effects of sex steroid hormones. Indeed, androgens and oestrogens influence a multitude of vascular biological processes and their cardiovascular effects are multifaceted. While in women the effects of androgens mainly depend upon oestrogens’ levels and, ultimately, upon the estradiol/testosterone ratio, the effects of androgens in men mostly relate to their aromatization into oestrogens. Oestrogens exert potential beneficial effects on the cardiovascular system in both sexes. In women, the effect of oestrogens, alone or in association with progestins, has been widely investigated, but data obtained from older patient populations have lead the medical community and the general public to misleading conclusions. Growing evidence supports the ‘timing hypothesis’, which suggests that oestrogen/hormone replacement therapy may increase CVD risk if started late after menopause, but produce beneficial cardiovascular effects in younger postmenopausal women. Because in men adequate interventional studies with testosterone are lacking, specific investigations should be performed.     

不同类型健身运动处方对女大学生心血管功能的影响

目的：研究探讨不同类型健身运动处方锻炼对女大学生心血管功能的影响，并比较其不同的健身效果。为提高女大学生课外体育锻炼的科学性、锻炼增强心血管功能的实效性提供实验参考。方法：通过制订以发展人体灵敏、力量、耐力、全面健康、增重、瘦身、速度及柔韧素质为主要内容的八套健身运动处方．并在大学课外活动中进行处方锻炼实验。结果：锻炼后各实验组脉压、血管弹性扩张系数、血管顺度、总血容量、微循环半更新率比锻炼前有不同程度增大，多数实验组主动脉排空系数比锻炼前增大，总外周阻力、左心室射血阻抗、血液黏度、微循环半更新时间、微循环平均滞留时间有不同程度的降低。结论：本实验制订的健身运动处方可有效增强女大学生的心血管功能．改善女大学生的血液状况，对女大学生微循环功能也有促进作用。     

多囊卵巢综合征的性激素、胰岛素抵抗与超声影像相关性分析

目的探讨多囊卵巢综合征(PCOS)患者血液中性激素及胰岛素抵抗的特征并分析与超声影像之间的相关性。方法对2010年4月至2013年12月来本院进行治疗的120例PCOS患者(PCOS组)及50例健康体检者(对照组)进行超声影像指标检查,包括卵巢间质面积(SA)、卵巢总面积(TA)并计算SA/TA比值,以及检测血液中卵泡生成激素(FSH)、黄体生成激素(LH)、LH/FSH、雌二醇(E2)、睾酮(TESTO)、催乳激素(PRL)。对PCOS组检测空腹血糖(FPG)和空腹胰岛素(FIN),计算稳态模型指数(HOMA-IR)来评估胰岛素抵抗。结果 PCOS组的LH、LH/FSH、TESTO、SA、SA/TA均明显高于对照组,PCOS组的SA、SA/TA与LH、LH/FSH、TESTO、HOMA-IR呈正相关。结论 PCOS患者性激素水平及胰岛素抵抗与超声影像指标具有相关性。     

Peptide hormones and risk for future cardiovascular events among prediabetics: a 20-year follow-up in the OPERA study

Abstract

Background: Prediabetes has proven to have many unfavourable impacts on the cardiovascular system.

Methods: The OPERA (Oulu Project Elucidating Risk of Atherosclerosis) study included 1045 middle-aged subjects followed from the years 1990–1993 to 2014. The focus was on peptide hormones.

Results: Plasma resistin levels were higher among prediabetics (p?=?.001), particularly impaired glucose tolerance (IGT) (p?<?.001), but not impaired fasting glucose (IFG) patients than among normal glucose tolerance (NGT) or diabetes groups. Diabetics showed lower resistin levels than IGT subjects (p?<?.001). IGT or diabetes groups showed lower adiponectin and higher leptin levels compared to the NGT group (p?<?.001). The IFG group had the highest blood pressure and left ventricular mass index, even higher than the diabetic group. Diabetics had the highest, prediabetics (IFG?+?IGT) intermediate and NGT the lowest risk for CVD events during follow-up (p?<?.001). Among prediabetics, high plasma ghrelin was an independent predictor of CVD events (p?<?.05) in the Cox regression analysis although it did not significantly improve either classification or discrimination of the patients.

Conclusions: Among glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics. Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.

• KEY MESSAGE

• Among glucose tolerance groups, patients with IGT had the highest resistin, but equally high leptin and low adiponectin levels as diabetics.

• Among prediabetics, ghrelin seems to predict independently cardiovascular events in the long term.

     

绝经后妇女冠心病患者性激素水平与同型半胱氨酸水平的相关性及其对血管内皮功能的影响

目的探讨绝经后女性冠心病(CHD)患者内源性性激素水平与血清同型半胱氨酸(Hcy)水平之间的关系以及对血管内皮功能的影响.方法测定44例正常绝经1年以上经冠状动脉造影检查证实为CHD的女性患者[Ⅰ组,平均年龄(62.21±0.85)岁]、36例正常绝经1年以上经冠状动脉造影检查排除CHD的女性患者[Ⅱ组,平均年龄(64.01±0.76)岁]和41例无CHD的健康育龄妇女[Ⅲ组,平均年龄(39.83±0.62)岁]的血清雌二醇(E2)、睾酮(T)和孕酮(P)以及Hcy 水平,应用B型超声观察静息和反应性充血时肱动脉内径并计算各自的内皮依赖性血管舒张率(FMD%)和非内皮依赖性血管舒张率(NTG%).结果 3组患者的血清E2和P水平比较差异均有统计学意义(P<0.05);Ⅰ组的E2(57.65±5.93) pmol/L和P水平(5.78±0.21) nmol/L均低于Ⅱ组(P<0.05),Ⅱ组的E2(92.63±6.71) pmol/L和P(6.64±1.01) nmol/L均低于Ⅲ组的E2(168.80±11.10) pmol/L和P(8.87±1.34) nmol/L(均P<0.01);Ⅰ组和Ⅱ组的Hcy水平均高于Ⅲ组(均P<0.05),以Ⅰ组增高更显著(P<0.01);Ⅰ组的FMD%和NTG%水平低于Ⅱ组和Ⅲ组(均P<0.05),且Ⅰ组和Ⅲ组的FMD%差异具有统计学意义(P<0.01);多元逐步回归分析显示,包括E2在内的3项指标与Hcy水平独立相关;包括E2在内的5项指标又与FMD%独立相关.结论绝经后女性CHD患者E2水平低于非CHD患者,女性高同型半胱氨酸血症是内皮功能障碍的危险因素之一,绝经后女性性激素水平下降可能引起血管内皮功能紊乱.     

老年多梗塞性痴呆的性激素变化及相关因素的探讨

目的 研究老年多梗塞性痴呆 (MID)的性激素。方法 采取放射免疫法测定老年 MID46例,老年非痴呆脑梗塞 (CI)62例,老年健康对照组 38例。结果 男性和女性 MID组和 CI组分别与对照组比较,睾酮 (T)值下降, E2/T增高,均有显著性差异 ,男性 MID组雌二醇 (E2)高于对照组。女性 MID组和 CI组分别与对照组比较, T值下降,有显著性差异,女性 E2更明显下降,催乳素 (PRL)和孕酮 (RPO)及 E2/T值无显著性差异。男性上 NID与 CI组分别比较 T、 PRO、 E2/T均无显著性差异。结论 老年 MID与 CI都存在着性激素失衡,其中男性以 E2/T增高,女性以 E2降低最为明显。     

年龄和代谢综合征对男性性激素的影响

目的调查成年男性血清性激素水平随年龄增长而发生的变化及代谢综合征对男性性激素水平的影响。方法筛选男性性激素研究和代谢综合征性激素研究的体检人员。共有103名20至69岁男性入组男性性激素研究,77名入组代谢综合征性激素研究。测定其血清总睾丸酮(T),性激素结合蛋白(SH-BG),脱氢异雄酮(DHEA),孕酮(P),雌二醇(E2),黄体生成素(LH),卵泡刺激素(FSH),并根据Verm eu len公式计算游离睾丸酮(CFT)和生物活性睾丸酮(BT),计算游离睾丸酮指数,睾丸酮分泌指数。结果T在20~岁间呈轻微的上升,30~岁间无明显的改变,60岁后呈下降趋势,CFT,BT,DHEA 40岁后随年龄增长渐下降,SHBG,LH,FSH于20~69岁间随年龄增长渐升高。对照组的T,SHBG,DHEA均较代谢综合征组高,LH,FSH,CFT,FTI较代谢综合征组低,E2,P,TSI,BT两组间无明显差别,但FSH,T,SHBG差异有统计学意义。结论这个横断面研究的结果提示男性在40岁后CFT,BT,FTI,DHEA逐渐降低,T在60岁后渐降低,SHBG于20岁后即逐渐升高。代谢综合征男性的T,SHBG,DHEA较低,但仍需进一步的研究证实。     

某部女新兵集训期性激素变化、月经紊乱及相关研究

目的:研究某部女新兵集训引起性激素、体质量及心理变化等对月经的影响.方法:选取45名女新兵分别在集训前、集训第3个月时检测体内性激素;对女新兵用问卷调查、症状自评量表测评及磅秤测量体质量等方法调查分别在集训前、中、后半年及1年月经、心理及体质量等变化.结果:集训中,女兵黄体期及卵泡期FSH、HL、P显著降低,E2、T、...     

Influence of sex and oestrogen replacement on the disposition of dexamethasone in rats

The disposition of dexamethasone (DXM, 2 mg/kg, iv) was studied in ovariectomized female rats treated with oestrogen (0.1 mg and 1 mg of oestradiol benzoate) and in male rats. Oestradiol replacement had no effect on body or liver weights or on the DXM pharmacokinetic parameters (CL, Vdss, AUC, MRT and t1/2) of the female groups. If the Vdss seemed slightly greater in male than in female rats, this difference disappeared after normalization based on body weight. In contrast, CL was greater in the male rats even after normalization. For all the animals, significant correlations were observed between body weight and Vdss (r = 0.731, P less than 0.001) or CL (r = 0.639, P less than 0.001). Terminal half life and MRT were negatively correlated with CL (r = -0.481, P less than 0.01 and r = -0.575, P less than 0.01, respectively) but not with Vdss. Although oestrogen replacement did not seem to affect the pharmacokinetics of DXM, the increase in the CL in male rats should be the main determinant observed between the sexes. These results are consistent with a slower metabolism found for various drugs metabolized by the cytochrome P-450 in female rats.     

The role of sex hormones in psychopathology: focus on schizophrenia

The example of schizophrenia is used to illustrate how sex hormones affect the presentation of illness and its treatment. Organization and activation effects of hormones are explained, and behavior is shown to result from a complex interplay of hormones, brain mechanisms, and social pressures. Sex differences in schizophrenia (in onset age, symptoms, antipsychotic, and other treatment) are consequences of this interplay and impact on the clinician's ability to diagnose, treat, prognosticate, and prevent the disability and distress of schizophrenia.     

利培酮对不同性别精神分裂症患者催乳素水平及甲状腺功能的影响

目的探讨利培酮对不同性别精神分裂症患者催乳素水平及甲状腺功能的影响。方法将50例男性精神分裂症患者设为男性组,50例女性精神分裂症患者设为女性组,均日服利培酮治疗,观察8周。于治疗前及治疗2周、8周末,采用阳性与阴性症状量表评定临床疗效,同时检测血清催乳素水平及甲状腺功能,并进行对比分析。结果治疗后两组阳性与阴性症状量表总分均较治疗前有显著性下降（P〈0．01）,同期两组间评分比较差异均无显著性（P〉0．05）。治疗后两组血清催乳素水平均较治疗前显著升高（P〈0．01）,女性组则呈持续性升高;女性组治疗前血清催乳素水平显著高于男性组（P％0．01）,治疗2周、8周末血清催乳素水平较男性组升高更显著（P〈0．01）。治疗后两组甲状腺功能各项指标检测结果与治疗前比较差异无显著性（P〉0．05）,同期两组间比较差异均无显著性（P〉0．05）。结论利培酮治疗精神分裂症患者的疗效显著,但对血清催乳素水平有不同程度的影响,对女性患者的影响更为显著;对患者的甲状腺功能无明显影响。     

Differences in perioperative cardiovascular outcomes in elderly male and female patients undergoing intra-abdominal surgery: a retrospective cohort study

ObjectivePerioperative cardiovascular events constitute the majority of complications in noncardiac surgery. Older and female patients have been less investigated. We aimed to evaluate differences in perioperative cardiovascular outcomes by age and sex.MethodsWe enrolled 1079 patients (57.5 ± 17.0 years, 42.6% women) undergoing intra-abdominal surgery from July 2007 to June 2008 and compared occurrence of perioperative cardiac events by age (≥65 vs. <65 years) and sex. Multivariable logistic regression was used to investigate associations between age, sex, and outcomes.ResultsAge ≥65 years was associated with perioperative myocardial infarction (MI) (odds ratio [OR] 2.9, 95% confidence interval [CI]: 1.3–6.6) and total cardiovascular events (OR 2.4, 95% CI: 1.3–4.2). Age ≥65 years was associated with higher perioperative MI risks in men (OR 4.7, 95% CI: 1.3–17.6) than in women (OR 3.1, 95% CI: 1.2–8.3). Advanced age was associated with heart failure in women (OR 13.9, 95% CI: 1.7–110.5). Female sex was a risk factor for heart failure in elderly patients (OR 4.2, 95% CI: 1.1–15.7).ConclusionsAdvanced age appeared to be associated with increased perioperative cardiac risk but differed by sex. Tailored strategies should be considered with respect to the patient’s sex.     

磁共振在诊断女童特发性中枢性性早熟中的应用价值及其与性激素的相关性

目的  研究磁共振在诊断女童特发性中枢性性早熟中的应用价值及其与性激素的相关性。方法  选取2019年9月~2021年10月我院收治的特发性中枢性性早熟女童58例作为性早熟组,再分别选取同期在我院体检的单纯乳房发育女童和健康女童58例作为乳房发育组和健康对照组,所有女童均进行垂体磁共振检查。比较3组临床体征、血清性激素水平及垂体情况,采用Pearson相关性分析法分析特发性中枢性性早熟女童垂体情况与体征和血清性激素水平的相关性。结果  性早熟组身高、体质量、骨龄超前指数及垂体高度均高于乳房发育组、健康对照组（P < 0.05）。性早熟组血清雌二醇水平高于乳房发育组和健康对照组,乳房发育组高于健康对照组（P < 0.05）,性早熟组血清黄体生成素水平、黄体生成素/卵泡刺激素高于乳房发育组（P < 0.05）。性早熟组垂体形态Ⅳ~Ⅴ级女童占比（84.48%）高于乳房发育组和健康对照组（15.52%、20.69%,P < 0.05）。Pearson相关性分析结果显示,特发性中枢性性早熟女童身高、体质量、骨龄超前指数及血清雌二醇、黄体生成素水平、黄体生成素/卵泡刺激素与垂体高度和垂体形态呈显著正相关关系（r=0.694、0.884、0.838、0.937、0.895、0.799和0.784、0.895、0.835、0.947、0.884、0.905,P < 0.05）。结论  与单纯乳房发育女童和健康女童相比,特发性中枢性性早熟女童身高、体质量、超前骨龄指数、血清性激素水平及垂体高度、垂体形态分级均更高,特发性中枢性性早熟女童垂体高度、垂体形态分级与身高、体质量、超前骨龄指数、血清性激素水平均呈显著正相关关系。     

健康中老年人性激素、神经血管耦合及认知功能的相关性

目的 以多模态MRI观察健康中老年人性激素、神经血管耦合及认知功能的相关性。方法 对43名认知能力正常的健康中老年志愿者采集MR高分辨3D T1WI、3D伪连续动脉自旋标记成像及静息态血氧水平依赖功能MRI(fMRI),并行标准化神经心理学评估；基于体素水平评价短程功能连接强度(sFCS)及脑血流量(CBF),计算CBF/sFCS,以评估神经血管耦合；采集外周静脉血，检测血清性激素水平。以相关性分析和中介分析观察性激素、神经血管耦合及认知功能的关系。结果 43名志愿者简易精神状态检查中位得分28.00(27.00,29.50)分，听觉语言学习测验(AVLT)-即刻评分为6.93±2.26,AVLT-延迟评分为7.10±3.97,AVLT-再认评分为13.00(12.00,14.00),词语流畅性测验评分为6.30(5.00,7.00),波士顿命名测试(BNT)评分为22.47±4.26;血清雌二醇44.77(47.44,131.84)pmol/L,促卵泡生成素(FSH)54.78(12.56,78.83)IU/L,黄体生成素(LH)19.72(7.57,30.13)IU/L,泌乳素(P...     

Body composition and serum lipids in female runners: influence of exercise level and menstrual bleeding pattern

Abstract. The impact of running and menstrual disturbances on regional and total body fat distribution and serum lipids was investigated in 205 women. Body composition was measured by dual-energy X-ray absorptiometry. The total fat mass in the elite runners was approximately half of the normally active's (7.3 [0.48] kg vs. 14.3 [0.49] kg, P < 0.001) (mean [SEM]). The difference was most pronounced in the abdomen (fat percentage 9.7 [0.85]% vs. 22.0 [0.88]%, P <0.001). The elite runners tended to have a more favourable lipid profile than the normally active (NS). A significant relation was found between lipoproteins and body fatness. In comparison with the regularly menstruating runners ( n = 93), the 13 runners with amenorrhea tended to have less body fat and slightly less favourable lipid profiles (NS). In conclusion, regular exercise was associated with a low abdominal fat percentage, which may affect cardiovascular risk beneficially. Running-associated menstrual dysfunctions were not significantly related to a specific body composition or serum lipid profile.     

大龄经产妇性激素水平调查及其对再生育的影响

目的：探讨性激素水平对大龄经产妇再生育的影响。方法回顾性分析2009年4月至2013年4月都江堰市医疗中心就诊的437例35岁以上经产妇的临床资料,按孕育结果分为正常孕育组（118例）和非正常孕育组（319例）,所有产妇均测定血清雌二醇（E2）、催乳素（PRL）、黄体生成素（LH）、促卵泡激素（FSH）、孕酮（P）和睾酮（T ）水平,探讨各性激素水平对大龄经产妇再孕再育的影响。结果非正常孕育组妇女血清E2水平明显低于正常孕育组,而PRL、LH、FSH水平明显高于正常孕育组,组间比较差异有统计学意义（P＜0．05）;多因素Logistic回归分析显示,影响大龄经产妇再孕再育的主要因素为E2和FS H。结论大龄经产妇中非正常孕育组血清FS H水平明显升高,E2、FS H水平是影响大龄经产妇不孕不育的主要因素。