更年期妇女血清E2和FSH水平的变化及其与骨密度的相关性

目的探讨更年期妇女血清雌二醇(E2)和卵泡刺激素(FSH)水平的表达与骨密度(BMD)的相关性。方法选取2011年1月至2013年12月在该院进行体检的200例更年期妇女,测定血清E2、FSH水平与腰椎、总髋部、股骨近端BMD,比较围绝经妇女与绝经妇女血清E2和FSH水平表达差异,并分析其与BMD的相关性。结果绝经前组年龄明显小于绝经组,血清E2水平高于绝经组,而FSH水平低于绝经组(P<0.05);绝经前组BMD高于绝经组(P<0.05);年龄、E2、FSH、绝经年龄、绝经时间与BMD具有相关性(P<0.05),血清E2与腰椎、髂骨、股骨上段BMD具有直线正相关性(r1=0.126,r2=0.328,r3=0.415,P<0.05),FSH水平与腰椎、髂骨、股骨上段BMD具有直线负相关性(r1=-0.115,r2=-0.223,r3=-0.486,P<0.05)。结论更年期妇女血清E2水平减低,而FSH水平增高,血清E2和FSH水平与绝经前后妇女的BMD具有相关性,可作为预测BMD的客观指标。     

老年女性脑梗死者下丘脑-垂体-卵巢轴功能变化研究

目的探讨绝经后老年脑梗死患者下丘脑垂体卵巢轴功能变化的特点及意义。方法采用放免法动态测定97例老年女性脑梗死患者血清促卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)及睾酮(T)的水平。分析其与病程、病情、梗死部位及梗死范围的关系。结果(1)老年女性脑梗死患者急性期血清FSH、LH、E2值下降,T值升高,与恢复期及对照组比较,差异有统计学意义(P<0.01);恢复期血清FSH、LH、E2、T同对照组相比,无显著差异(P>0.05)。(2)急性期中、重型组血清FSH、E2、T的水平明显高于轻型组,差异有统计学意义(P<0.05);2组间血清LH无明显差异(P>0.05)。(3)急性期皮质组、皮质下组、混合组比较,梗死范围≥2cm×2cm×2cm组与梗死范围<2cm×2cm×2cm组比较,血清FSH、LH、E2、T值均无显著差异(P>0.05)。结论老年女性脑梗死患者急性期存在下丘脑垂体卵巢轴功能紊乱,随着疾病的好转趋于正常。且这种紊乱不受梗死部位及梗死范围的影响,与病情程度密切相关。     

绝经后性激素变化在糖尿病发病中的作用

测定绝经后妇女2型糖尿病患者及相应对照者的血清雌二醇(E2)、孕酮(P)、促卵泡刺激素(FSH)、促黄体生成素(LH)及睾酮(T)水平.结果显示绝经后妇女2型糖尿病组E2水平明显低于对照组,而FSH、LH、T水平显著高于对照组.提示雌激素水平过低及雄激素水平过高可能是绝经后妇女2型糖尿病发病的危险因子.     

丹参酮对绝经后妇女冠心病过氧化物及脂质代谢的影响

目的:探讨丹参酮对绝经后妇女冠心病(CHD)的保护作用.方法:选138例绝经后CHD患者,随机分为对照组、尼尔雌醇组和丹参酮组,分别给予安慰剂(2片.月-1.次-1),尼尔雌醇(2mg.月-1.次-1)及丹参酮(3片/次,每日2次),6个月.分别于0、3、6个月末抽血测血清雌二醇(E2)、一氧化氮(NO)及低密度脂蛋白胆固醇(LDL-C)水平.结果:治疗前3组患者E2水平,不存在差异;干预治疗6个月后,①尼尔雌醇组和丹参酮组E2水平均升高显著(P<0.01);②尼尔雌醇组和丹参酮组血清NO含量均增高显著(P<0.01,P<0.001);③丹参酮组LDL-L水平显著下降,尼尔雌醇组的亦有下降(P<0.01,P<0.05).结论:丹参酮对绝经后妇女冠心病的心血管保护作用比尼尔雌醇更为明显.     

雌二醇对绝经后高血压妇女左室舒张功能的影响

目的评价生理剂量雌二醇对合并左室舒张功能不全的绝经后高血压妇女左室舒张功能的影响。方法将30名绝经后高血压的妇女合并左室舒张功能不全分成观察组(n=17,口服雌二醇)及对照组(n=13,安慰剂),治疗前与治疗20周后检查性激素浓度(E_2、FSH、LH)及左室舒张功能(E峰、A峰、E/A、Ea峰、Aa峰、Ea/Aa)。结果观察组妇女20周后性激素浓度显著改变,E_2显著升高,而FSH、LH显著下降,差异均有非常显著性意义(P＜0．01),左室舒张功能E/A、Ea峰、Ea/Aa较治疗前提高,与对照组差异亦有显著性意义(P＜0．05),而对照组无变化。结论经20周雌激素替代治疗,绝经后高血压妇女左室舒张功能有显著提高。     

绝经后性激素变化在糖尿病发病中的作用

测定绝经后妇女2型糖尿病患及相应对照的血清雌二醇（E2）、孕酮（P）、促卵泡刺激素（FSH）、促黄体生成素（LH）及睾酮（T）水平。结果显示：绝经后妇女2型糖尿病组E2水平明显低于对照组,而FSH、LH、T水平显高于对照组。提示：雌激素水平过低及雄激素水平过高可能是绝经后妇女2型糖尿病发病的危险因子。     

大豆异黄酮对转基因MMTV-erbB-2小鼠乳腺癌相关激素及受体的效应

目的研究大豆异黄酮对转基因MMTV-erbB-2小鼠的乳腺癌相关激素及受体效应。方法选择20²2 g的雌性转基因MMTVerbB-2小鼠80只,其中40只给予大豆异黄酮进行饲养作为观察组,另40只给予普通饲料作为对照组。比较两组小鼠体重、肿瘤发生率、潜伏期;检测比较两组小鼠未发生肿瘤乳腺组织中睾酮(T)、雌二醇(E2)、泌乳素(PRL)、促黄体生成素(LH)和促卵泡激素(FSH)的含量,雌激素受体(ER)、孕激素受体(PR)、增殖细胞核抗原(PCNA)阳性表达率。结果观察组小鼠体重下降与对照组比较差异有统计学意义(P<0.01);观察组与对照组肿瘤潜伏期无明显差异(P>0.05);观察组肿瘤发生率低于对照组(P<0.01);观察组的E2、T、PRL水平显著高于对照组(P<0.05);观察组的FSH和LH水平显著低于对照组(P<0.01);两组ER、PR受体阳性率差异无统计学意义(P>0.05);观察组PCNA阳性率大于对照组,差异具有统计学意义(P<0.05)。结论大豆异黄酮可以降低转基因小鼠MMTV-erbB-2的肿瘤发生率,提高PCNA阳性表达率。     

绝经后妇女雌激素缺乏与外周血T淋巴细胞亚群改变的关系研究

目的 通过多省市流行病学调查,探讨绝经后妇女血清性激素水平与外周血T淋巴细胞亚群的变化及两者之间的关系。方法 以816例健康绝经后妇女为研究对象,369例未闭经妇女为对照组,用放射免疫法测定血清促卵泡激素(FSH)、黄体生成素(LH)、垂体泌乳素(PRL)、睾酮(T)、游离睾酮(FT)、17-β雌二醇(17β-E_2)及孕酮(P),用流式细胞仪测定T淋巴细胞亚群。结果 与对照组相比,绝经后血清17β-E_2,P水平明显下降,闭经后17β_E_2仍有下降趋势,>70岁P有所回升,E_2/P比值随增龄明显下降。闭经后T明显升高,但FT变化不明显。血清FSH,LH浓度随增龄增加,绝经后各组与对照组相比,差异均有显著性意义,但闭经后各组间差异无显著性意义。PRL值有所下降,但各组间差异无显著性意义。经线性相关分析,17β-E_2,E_2/P与年龄呈负相关(r=-0.472,P<0.001;r=-0.221,P<0.001)。CD_3~+,CD_4~+在≤60岁与对照组相比变化不明显,>60岁CD_3~+有所下降,CD_4~+则明显下降,CD_8~+绝经后各组与对照组相比无变化,CD_4~+/CD_8~+比值随增龄明显下降。经线性相关分析CD_3~+,CD_4~+与年龄呈负相关(r=-0.224,P<0.05;r=-0.298,P<0.001)。经线性相关分析CD_3~+,CD_4~+与E_2呈正相关(r=0.356,P<0.001;r=0.454,P<0.001),而CD_8~+与E_2无相关。以年龄、体重指数     

子宫切除术对卵巢功能的影响

选择因子宫肌瘤、子宫腺肌病于绝经前行单纯子宫切除术的患者30例作为观察组,选择阴道炎、宫颈炎未绝经患者10例作为对照组,用放免方法测定观察组术后1、3、5 a血清促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E2)、孕酮(P);对照组统一测上述指标.与对照组相比,观察组术后E2、P水平随手术时间的延长而呈下降趋势,FSH、LH水平呈上升趋势.认为子宫切除术后卵巢功能下降.     

血清性激素水平与老年女性代谢综合征的关系

目的探讨老年女性血清性激素水平与代谢综合征(MS)的关系。方法选择2013年1月至2014年1月在该院体检的168例绝经后的老年女性,根据检查结果分为健康组(78例)和MS组(90例),测定所有受试者血清中雌二醇(E2)、黄体生成素(LH)、卵泡雌激素(FSH)、性激素结合球蛋白(SHBG)、总睾酮(TT)、游离睾酮(FT)、脱氢表雄酮(DHEA)、血脂、血糖,测量身高、体重和血压。结果健康组三酰甘油(TG)、空腹血糖(FBG)、体重指数(BMI)水平和血压远远低于MS组,高密度脂蛋白胆固醇(HDL-C)远远高于MS组(P>0.05);健康组E2、LH、FSH、SHBG和E2/TT显著高于MS组,而TT显著低于MS组(P<0.05);E2、SHBG与MS及组分间呈负相关(P<0.05),TT与MS及组分呈正相关(P<0.05),且逐步回归分析表明雌激素为MS发病的主要危险因素(P<0.05)。结论女性绝经后性激素急剧降低,增加MS的危险,适当补充雌激素,调节SHBG水平,对于降低MS发病率具有重要意义。     

绝经后代谢综合征女性雌激素水平的变化

目的观察绝经后代谢综合征(metabolic synd rome,MS)女性雌激素及性激素结合球蛋白的变化。方法随机调查绝经期后女性168例,其中健康体检者78例(对照组),MS患者90例(MS组)。测静脉血雌二醇、性激素结合球蛋白、黄体生成素及卵泡刺激素水平。结果与绝经≤10年女性比较,绝经11～20年、≥21年的对照组和MS组女性雌二醇均明显降低,差异有统计学意义(P0.05)。与对照组比较,MS组女性绝经≤10年、11～20年、≥21年者体重指数明显升高,性激素结合球蛋白明显降低;绝经≤10年女性雌二醇、黄体生成素、卵泡刺激素明显降低,绝经11～20年女性卵泡刺激素、黄体生成素明显降低,差异有统计学意义(P0.05,P0.01)。结论低雌激素水平对代谢的影响在绝经10年内;低性激素结合球蛋白水平是预示绝经后女性MS的独立危险因素。     

冠心病患者性激素水平失衡的研究

目的 :研究冠心病患者性激素水平的变化。方法 :选择冠心病患者 5 0例 ,用放射免疫法测定血清雌二醇 （E2 ）、孕酮 （P）、促卵泡刺激素 （FSH）、促黄体生成素 （L H）、睾酮 （T）、泌乳素 （PRL）及生长激素 （GH）的变化 ;采用酶法观测空腹总胆固醇 （TC）、甘油三酯 （TG）、高密度脂蛋白 （HDL）及低密度脂蛋白胆固醇 （L DL- C）的变化。结果 :1男性冠心病组与对照组比 E2 、P均升高 （P<0 .0 5 ） ,T水平亦明显下降 （P<0 .0 1） ;女性冠心病组与对照比 ,P水平均显著升高 （P<0 .0 1） ,E2 水平下降 （P<0 .0 5 ）。 2男性冠心病患者 TC,TG,L DL- C均显著高于对照组 （P<0 .0 1） ,HDL 显著低于对照组 （P<0 .0 1） ;女性冠心病患者 TC,TG,L DL- C均高于对照组 （P<0 .0 5 ） ,HDL 低于对照 （P<0 .0 5 ）。结论 :冠心病患者存在血脂代谢异常。但男性与女性冠心病患者的性激素水平失衡存在差异 :男性 E2 ,P升高 ,T降低 ,女性 P升高 ,E2 降低     

藏族男性肝病患者下丘脑-垂体-性腺轴功能的变化及其临床意义

目的　探讨藏族男性肝病患者下丘脑 垂体 性腺轴的变化 ,了解不同类型肝病患者性腺激素水平的变化 ,协助临床对病情和预后的判断。方法　于 1999- 12～ 2 0 0 4 - 0 4在西藏自治区第二人民医院随机选择西藏地区藏族男性肝病患者 93例 ,包括甲型肝炎、乙型肝炎、酒精性肝病、肝硬化及重症肝炎。同时选取西藏地区 19名健康藏族男性作为对照。测定入选者睾酮 (T)、雌二醇 (E2 )、卵泡刺激素 (FSH)、黄体生成素 (LH )、泌乳素(PRL)及促性腺激素释放激素 (LHRH)的水平。资料统计采用双侧 t检测。结果　肝病患者E2 、PRL和LHRH水平与对照组比较均有显著性差异 (P <0 0 1、P <0 0 1、P <0 0 5 )。急性肝炎T、E2 、PRL升高 ,E2 升高 (P <0 0 1、P <0 0 5、P <0 0 1)。出现高雌激素血症和低睾酮血症 :重症肝炎T、FSH、LH、LHRH降低 (P <0 0 1、P<0 0 5、P <0 0 5、P <0 0 1) ,E2 、PRL升高 ,均为P <0 0 1。结论　性激素水平的变化与肝功能受损程度相一致 ,因此临床上测定性激素水平对了解病情、判断预后有着一定的作用。     

前列腺癌患者性激素与促性腺激素的变化

目的探讨性激素和促性腺激素对前列腺癌的影响。方法对1996-01-01—2005-12-31解放军总医院内分泌科测定53例确诊未治的前列腺癌患者性激素:睾酮(T)、雌二醇(E2)与促性腺激素,包括黄体生成素(LH)、卵泡刺激素(FSH),同时测定了253名正常对照者的性激素与促性腺激素。结果前列腺癌组总睾酮和反映游离睾酮的指标睾酮分泌指数(TSI)以及FSH均低于正常对照组,且均有统计学意义(P<0·05)。E2、LH两组比较无统计学意义(P>0·05)。结论(1)前列腺癌患者处于低雄激素水平。(2)当睾酮(正常为15nmol/L)或睾酮分泌指数(正常为4·0)低于诊断标准时,前列腺癌的发病率可能升高。     

Altered neuroendocrine regulation of luteinizing hormone secretion in postmenopausal women with Parkinson's disease.

The secretion of gonadotropins and the role exerted by the endogenous opioid system on luteinizing hormone (LH) secretion were investigated in 6 postmenopausal women affected by idiopathic Parkinson's disease (PD) as well as in 6 age- and weight-matched normal postmenopausal women as controls. The mean plasma follicle-stimulating hormone (FSH) and LH levels were evaluated both under basal conditions and after 20 days of conjugated estrogen administration (1.25 mg/day). At the same time, the activity of the endogenous opioid system was evaluated, as well as the LH response to the 4-hour infusion of the opioid antagonist naloxone (1.6 mg i.v. bolus followed by 1.6 mg/h). Both before and during estrogen administration, plasma FSH levels were similar in the two groups of subjects, whereas plasma LH levels were significantly lower (p less than 0.01) in parkinsonian than in control women. In each subject estrogen administration significantly blunted (p less than 0.01) plasma FSH levels. Plasma LH levels were reduced only in controls (p less than 0.05), but not in women with PD. In each subject, before estrogen administration, the plasma LH levels did not vary during naloxone infusion. In control women after 20 days of estrogen administration, the plasma LH levels significantly increased during naloxone infusion (p less than 0.01). By contrast, in women with PD, conjugated estrogens failed to restore the LH response to naloxone. The present results suggest that the neurotransmitter mechanisms, which regulate LH secretion, are altered, and, in particular, the activity of the endogenous opioid system is deficient in women with PD.     

Sex hormone status in women suffering from rheumatoid arthritis

We studied the sex hormone status of 21 seropositive (IgM-RF) women with rheumatoid arthritis (RA), who were subdivided according to their premenopausal and postmenopausal status. Age matched women with secondary osteoarthritis were used as controls. The hormones evaluated were luteinizing hormone (LH), follicle stimulating hormone (FSH), prolactin (PRL), 17-beta-estradiol (E2), progesterone (Pg), testosterone (T), delta 4-androstenedione (A), dehydrotestosterone (DHT), dehydroepiandrosterone sulphate (DHEAS) and cortisol (C). Normal concentrations of all the hormones considered were found in premenopausal women with RA. Statistically higher concentrations of T (p less than 0.05), A (p less than 0.05) and DHEAS (p less than 0.01) were observed in postmenopausal women with RA when compared to controls, whereas no differences were found for all other hormones studied. Although the significance of observed relative hyperandrogenism in postmenopausal women with RA is not clear, our data seem to indicate that sex hormone levels are altered in patients with RA.     

PITUITARY-OVARIAN FUNCTION IN NORMAL WOMEN DURING THE MENOPAUSAL TRANSITION

The excretion of follicle stimulating hormone (FSH), luteinizing hormone (LH), oestrogens and pregnanediol was measured in weekly urine samples collected for 14–87 weeks (median, 43 weeks) from thirty-one perimenopausal women aged 36–55 years (median, 50 years). The results were compared with those found in twenty-two postmenopausal women aged 55·4 ± 5·4 years (mean ± SD), and in twenty premenopausal women aged 44·4 ± 3·4 years with regular, ovulatory, menstrual cycles. Women classed as perimenopausal had a recent history of irregular menstrual cycles following regular cyclicity. The hormone patterns observed in the perimenopausal women varied widely, both between individuals and from time to time in the same individual. They ranged from ovulatory cycles with low premenopausal levels of FSH, to transient episodes indistinguishable from those found in postmenopausal women with high levels of FSH and LH. Between these extremes were patterns rarely seen at other times in reproductive life: namely, (1) in fourteen women on thirty-two occasions lasting 2–9 weeks, postmenopausal levels of FSH and LH occurred in association with high oestrogen levels; (2) in eighteen women on thirty occasions lasting 2–8 weeks, there was an elevation of LH (but not FSH) into the postmenopausal range; (3) in thirteen women on twenty-six occasions lasting 1–2 weeks, there was an elevation of FSH (but not LH) into the postmenopausal range. These patterns were not seen in any of the premenopausal women. Typically, the approach of the menopause was marked by an increased incidence of high postmenopausal levels of FSH and LH. Ovulatory cycles were observed at all stages in the perimenopause, and occurred within 16 weeks of the last menstrual period in seven of the thirteen women who became postmenopausal during the study. It is concluded that the appearance of high levels of FSH and LH is characteristic of the perimenopause and often precedes the sustained loss of sex hormone secretion by the ageing ovary. Postmenopausal biochemical parameters are no guarantee of the postmenopausal state.     

绝经后女性冠心病患者性激素水平与年龄及高敏C反应蛋白的相关性分析

目的探讨绝经后女性冠心病患者性激素水平变化与年龄及高敏C反应蛋白(hs-CRP)的相关性。方法选择正常绝经时间≥1年的无性激素替代治疗的女性患者362例,根据冠状动脉造影结果分为冠心病组127例和对照组235例。其中年龄≤60岁患者107例;61～70岁患者113例;70岁患者142例。检测血浆雌二醇、睾酮、血脂和hs-CRP水平,分析不同年龄段冠心病患者性激素水平与hs-CRP的相关性。结果与对照组同年龄段比较,冠心病组≤60岁患者雌二醇、雌二醇/睾酮明显降低,睾酮明显升高(P0.05,P0.01),年龄61～70岁和70岁患者hs-CRP明显升高(P0.01)。性激素水平与年龄呈负相关,与体重指数呈正相关(P0.05,P0.01)。logistic回归分析显示,雌二醇是冠心病的重要保护因子(P0.01)。结论绝经后初期,女性冠心病患者性激素水平失衡明显,而年龄60岁患者血脂及炎症水平明显升高,绝经后不同年龄段女性防治策略应有所不同。     

The pituitary-gonadal axis in women with benign or malignant ovarian tumors.

The serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), human chorionic gonadotropin (hCG), estradiol, progesterone, androstenedione, testosterone (total and free) and dehydroepiandrosterone sulphate (DHEAS) were investigated prior to surgery in 24 postmenopausal women with benign and 28 postmenopausal women with malignant epithelial ovarian tumors. The serum concentrations of hormones were compared with those of 28 healthy, postmenopausal, age-matched controls. Significantly lower serum FSH levels were demonstrated in women with malignant tumors. No significant differences were found between the groups regarding the serum LH levels. The hCG levels were low in all groups. Regarding progesterone and estradiol levels, low postmenopausal steroid levels were found in all groups examined and no significant differences were demonstrated within the groups. No significant correlations between the levels of estradiol and FSH or progesterone and LH were demonstrated. To exclude a central depression of gonadotropin release mediated by the dopaminergic system we examined the thyroid stimulating hormone (TSH) and prolactin. No differences were found between the groups regarding TSH and prolactin levels. A possible relationship between other hormones/factors produced by the tumor and exerting a negative feedback, either centrally or directly, on the gonadotropin release remains to be investigated. A change in biological activity in the gonadotropins might explain the present findings.     

Association of follicle stimulating hormone and serum lipid profiles in postmenopausal women

The aim of the study was to observe the association between follicle stimulating hormone (FSH) levels and serum lipid profiles in postmenopausal women. A total of 411 healthy postmenopausal women with a mean age of 55 years (range 45–65 years) were enrolled in this study. Data on age, time of last menstrual period, past medical history, use of medications, and smoking status were collected, and body weight, height, and blood pressure were measured. Blood samples were collected to measure the serum concentrations of FSH, luteinizing hormone (LH), estradiol (E2), glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) using routine methods. FSH levels were negatively associated with LDL-C, even after adjustment for age, LH, E2, BMI, systolic blood pressure (SBP), and diastolic blood pressure (DBP) (OR = 0.185, 95% CI = 0.051‐0.669). Although FSH may also be negatively associated with dyslipidemia (P = .06 for trend) and hypercholesterolemia (P = .079 for trend), but no statistical significance was found after adjusting for confounding factors, particularly BMI. All relevant data are within the paper and its Supporting Information files. The results indicated that lower FSH levels might increase the odds of dyslipidemia, especially the risk of LDL-C elevation, which is an important factor that increases the risk of CVD in postmenopausal women.