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Maturitas:激素补充治疗和替勃龙对绝经后女性脂蛋白水平的影响

2017-06-28 唐瑞怡 邓姗 协和妇产科文献月报

目的:脂蛋白(a)[Lp(a)]是心血管疾病的一项独立危险因素,关于激素补充治疗(HRT)和替勃龙对Lp(a)的影响存在争议。在本文的mata分析中,探究HRT和替勃龙对绝经后女性Lp(a)浓度的影响。

目的:脂蛋白(a)[Lp(a)]是心血管疾病的一项独立危险因素,关于激素补充治疗(HRT)和替勃龙对Lp(a)的影响存在争议。在本文的mata分析中,探究HRT和替勃龙对绝经后女性Lp(a)浓度的影响。

设计和方法:检索MEDLINE, Scopus, EMBASE 和Cochrane数据库(至2017年2月10日),由2名研究者检索随机对照试验并提取数据。由第三位研究者解决潜在的争议。

结果:在24项入选的研究中,将HRT组与安慰机组或未治疗组比较,发现HRT导致Lp(a)水平显着下降[平均相对差: -20.35%,95%置信区间(CI): -25.33%到 -15.37%,p < 0.0001],不同研究间存在显着异质性(I2= 98.5%),但没有发表偏倚。而替勃龙(n=7)(2.5mg/d)使Lp(a)有下降倾向,但未达到显着意义(平均相对差: -23.84%, 95% CI: -63.43% 到 15.74%, p = 0.238) (I2 =98.7%, 没有出版偏倚)。口服雌激素比经皮雌激素(50μg,每周两次)导致Lp(a)水平更明显的降低(n=10) (平均相对差: 37.66%,95% CI: 16.84% 到58.48%, p < 0.0001),研究之间存在显着异质性(I2 = 99%)。HRT连续方案与序贯方案相比,传统剂量与低剂量雌激素相比,单用雌激素与雌孕激素联合相比较,均未发现显着差异。HRT与替勃龙对Lp(a)的影响也无显着差异。

结论:绝经后女性HRT显着降低Lp(a)水平,口服雌激素比经皮雌二醇作用更明显。HRT的方案、雌激素剂量、是否添加孕激素均不改变HRT可降低Lp(a)这一效应.

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    2017-12-01 hxzhang
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    2017-06-30 zxxiang

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2013年,以国际绝经协会(IMS)为代表的全球绝经协会,举办了一场研讨会,达成了绝经激素治疗的全球共识声明,为卫生健康提供者和潜在的绝经期激素疗法(MHT)使用者提供了治疗指南。 2016年,IMS、内分泌学会、欧洲绝经学会、亚太绝经联盟、国际骨质疏松基金会和拉丁美洲绝经协会联合会在此基础上,对该指南进行了修订,旨在更新扩展共识内容。希望可以帮助卫生健康提供者为那些可能受益 MHT 的中年女性

Nature:阻断FSH荷尔蒙受体抑制绝经后导致的肥胖和骨流失

这项研究揭示了FSH蛋白是如何在低雌激素的情况下,导致肥胖和骨质疏松的,并且提出通过采用阻断抗体从而抑制和延缓这一因为绝经而导致的肥胖和骨流失,为将来开发药物提供了理论基础。

指南:绝经后乳腺癌患者血脂异常的处理

雌激素可影响脂蛋白类型和血脂水平,对于心血管系统有一定的保护作用。绝经后乳腺癌患者由于受到药物治疗和卵巢功能的减退的双重影响,从而导致雌激素水平的明显下降。由于雌激素水平的下降导致血脂异常,进而导致心血管疾病的患病风险增加。因此规范处理乳腺癌患者的血脂异常,能够有效降低有效地降低绝经后乳腺癌患者动脉粥样硬化性心血管疾病(ASCVD)的风险,进一步改善乳腺癌患者的长期生存状况。

Hypertension:生小孩越早绝经后患高血压的风险越大!

首次分娩的年龄与绝经后妇女高血压显著相关。体重指数介导了首次分娩年龄对高血压的效应。

World Cancer Research Fund:每天半杯酒也会增加乳腺癌风险!

近日,世界癌症研究基金会作了一个关于饮酒和乳腺癌风险的报告:每天喝半杯酒或喝一小杯啤酒会增加患乳腺癌的风险。同时,他们也支持关于定期强化锻炼能够降低乳腺癌发病风险的研究。

JAHA:牙周炎和无牙症病史可以预测绝经后妇女心血管疾病、卒中和死亡率

在社区居住的老年妇女中,无牙症与心血管疾病和总死亡率风险增加有关。牙周炎这比无牙症更为普遍,与死亡率增加17%相关。这些研究结果表明改善一般人群的牙周状况可以降低总死亡率。

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