绝经后潮热妇女血浆5-羟色胺前体及代谢产物水平的变化

目的　探讨更年期妇女血浆 5 羟色胺 (5 HT)代谢的变化与潮热之间的关系。方法　采用高效液相色谱 荧光检测器 ,测定 2 0例绝经过渡早期 年龄 (46± 3 )岁 ]、2 6例绝经过渡后期 (绝经≤1年 )、2 8例绝经 1～ 3年、2 4例绝经 3～ 6年及 12例正常育龄 (2 0～ 3 0岁 )妇女血浆中色氨酸 (TP)、5 羟色氨酸 (5 HTP)、5 HT、5 羟吲哚乙酸 (5 HIAA)及绝经后妇女血浆促黄体生成素 (LH)的水平 ;对绝经后妇女采用Kupperman评分法评分 ,其中潮热次数≤ 5次 /d(轻度潮热 )的有 2 0例 ,>5次 /d(重度潮热 )的有 15例 ,无潮热者 17例 ,分析 5 HT代谢变化与绝经时间、LH水平和潮热之间的关系。结果　 (1)绝经过渡早期妇女血浆 5 HT、绝经过渡后期和绝经 1～ 3年妇女的血浆 5 HT及 5 HIAA水平 ,显著高于育龄妇女 (P <0 0 1) ,绝经 3～ 6年妇女的血浆 5 HTP和 5 HT水平高于育龄妇女 ,而 5 HIAA水平则低于育龄妇女 (P <0 0 5 )。 (2 )绝经后妇女血浆 5 HT水平与LH水平间呈正相关 (r2 =0 5 3 0 7,P<0 0 1)。(3 )绝经后有轻度潮热者的血浆 5 HTP水平、重度潮热者血浆 5 HTP和 5 HT水平均高于无潮热者 (P均 <0 0 5 ) ,重度潮热者 5 HIAA/ 5 HT比值则显著降低 (P <0 0 5 )。结论　绝经后妇女 5 HT

Changes of plasma serotonin precursor metabolite concentrations in postmenopausal women with hot flushes

OBJECTIVE: To investigate the relationship between changes of serotonin metabolism and hot flushes in climacteric women. METHODS: Ninety seven climacteric women, aged 40 - 60 were enrolled and divided into 4 groups, group A: early menopausal transition 20 cases, group B: late menopausal transition, 26 cases with skip of periods 3 - 12 months, group C: early postmenopause (1 - 3 years) 28 cases, group D: late postmenopause (> 3 - 6 years) 24 cases. Twelve normal women of reproductive age were served as young controls. Fifty two postmenopausal women were subdivided into 3 groups according to presence or absence of hot flushes. (1) postmenopausal controls without hot flush, 17 cases, (2) mild hot flushes group fewer < or = 5 times/day. (3) severe hot flushes group more than 5 times/day. Plasma concentrations of tryptophan (TP), 5-hydroxytryptophane (5-HTP), 5-hydroxytryptamine (5-HT or serotonin) and 5-hydroxyindoleacetic acid (5-HIAA) were measured in all participants by high pressure liquid chromatography-fluorescence spectrophotometer. Plasma level luteinizing hormone (LH) was measured in postmenopausal women by radioimmuno assay. The relationship between serotonin metabolic parameters and menopause, hot flushes and LH level were analysed. RESULTS: (1) Mean 5-HT and 5-HIAA concentrations in plasma were significantly higher in climacteric women than those in young controls, especially in the group B. Mean 5-HTP and 5-HT levels were higher and 5-HIAA lower in group D as compared with those of young controls. (2) Plasma 5-HT levels was positively correlated to luteinizing hormone concentration in postmenopausal women (P < 0.001). (3) In the mild hot flushes group, only plasma 5-HTP levels was significantly higher than that in the postmenopausal control group. In severe hot flushes group, plasma 5-HT and 5-HTP contents were significantly higher and 5-HIAA/5-HT ratio lower than those in the postmenopausal control groups. CONCLUSION: Our results suggest that the catabolic disorder of serotonin may involve in the underlying mechanism of hot flushes in postmenopausal women.