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JCEM:产前己烯雌酚暴露与心血管疾病风险有何关系?

2017-10-21 xing.T MedSci原创

这些数据表明,在产前DES暴露与CAD和MI相关,而与卒中无关,这种相关性似乎独立于已知的心血管疾病危险因素。

产前暴露于己烯雌酚(DES),一种典型的内分泌干扰物,与女性不良生育结局和癌症风险相关。近日,内分泌和代谢性疾病领域权威杂志Journal of Clinical Endocrinology & Metabolism上发表了一篇研究文章,研究人员旨在明确产前DES暴露的女性发生心血管疾病(CVD)的风险可能会更大。

从1994年至2013年期间,研究人员对参与乙烯雌酚联合队列随访研究的DES暴露(n=3941)与对照组(n=1705)妇女进行了前瞻性地随访。在出生记录或医生的病例中记录了产前DES暴露(或缺乏暴露)。参与者通过问卷调查报告了“需要住院、手术或长期治疗” 的严重疾病,包括冠心病(CAD)、心肌梗死(MI)和卒中。研究人员寻求医生对参与者自我报告进行验证,并从国家死亡指数确定了CVD死亡。在调整了出生年份、原始队列和潜在混杂因素后,研究人员从估计己烯雌酚暴露与心血管疾病的发病率之间的关系的Cox比例风险回归模型中得到风险比(HR,和95%可信区间)。

研究人员发现相比于未暴露的女性,DES暴露的女性,报告CAD的HR为1.74(1.03-2.93),报告MI的HR为2.20(1.15-4.21),报告卒中的HR为1.01(0.54-1.90),以及报告联合疾病的HR为1.31(0.93-1.86)(即所有CVD)。对于验证的结果(CAD为1.72、MI为2.67、卒中为0.92,以及所有CVD为1.25)以及额外对高血压糖尿病和高胆固醇进行调整后(CAD为1.67,MI为2.04、卒中为0.96、以及所有CVD为1.24)也有相似的HRs。

这些数据表明,在产前DES暴露与CAD和MI相关,而与卒中无关,这种相关性似乎独立于已知的心血管疾病危险因素。

原始出处:

Rebecca Troisi,et al. A Prospective Cohort Study of Prenatal Diethylstilbestrol Exposure and Cardiovascular Disease Risk. J Clin Endocrinol Metab. 2017. https://doi.org/10.1210/jc.2017-01940

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    2018-01-22 smallant2015
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    2018-02-09 achengzhao
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  5. [GetPortalCommentsPageByObjectIdResponse(id=1777677, encodeId=72151e776778d, content=<a href='/topic/show?id=eb9610265ed' target=_blank style='color:#2F92EE;'>#JCEM#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10265, encryptionId=eb9610265ed, topicName=JCEM)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2a4439169927, createdName=smallant2015, createdTime=Mon Jan 22 00:23:00 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2063059, encodeId=bd37206305915, content=<a href='/topic/show?id=14fb10264d7' target=_blank style='color:#2F92EE;'>#JCE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=101, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10264, encryptionId=14fb10264d7, topicName=JCE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e656479, createdName=achengzhao, createdTime=Fri Feb 09 11:23:00 CST 2018, time=2018-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1473078, encodeId=623814e307888, content=<a href='/topic/show?id=862be0746bc' target=_blank style='color:#2F92EE;'>#疾病风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70746, encryptionId=862be0746bc, topicName=疾病风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3c757221906, createdName=花花1368, createdTime=Mon Oct 23 02:23:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1498304, encodeId=06c8149830425, content=<a href='/topic/show?id=bb6f89e145a' target=_blank style='color:#2F92EE;'>#血管疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89714, encryptionId=bb6f89e145a, topicName=血管疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ccb99370406, createdName=andy2090, createdTime=Mon Oct 23 02:23:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1502515, encodeId=493f1502515a1, content=<a href='/topic/show?id=ef4b2441971' target=_blank style='color:#2F92EE;'>#产前#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=24419, encryptionId=ef4b2441971, topicName=产前)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b49a9545081, createdName=qilu_qi, createdTime=Mon Oct 23 02:23:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=255034, encodeId=7fcf25503483, content=很好很好很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/10/07/8c1e5a0085f3b74f3a4ab58a38a3d487.jpg, createdBy=b33e2159612, createdName=2227437833_79976374, createdTime=Sun Oct 22 07:54:03 CST 2017, time=2017-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254871, encodeId=f4a52548e129, content=学习了新知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=86, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201006/4db877c2887649beb09cb5effd0b38c7/916f66edd48a4e77b20ebc3e14b6e45c.jpg, createdBy=141e1980133, createdName=Y—xianghai, createdTime=Sat Oct 21 12:41:33 CST 2017, time=2017-10-21, status=1, ipAttribution=)]
    2017-10-23 qilu_qi
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    2017-10-22 2227437833_79976374

    很好很好很好

    0

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    2017-10-21 Y—xianghai

    学习了新知识

    0

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研究要点: 1.本项研究旨在比较生物可降解聚合物涂层药物涂层洗脱支架(DES)、裸金属支架和不可降解聚合物涂层DES的安全性与疗效。 2.生物可降解聚合物涂层DES的长期疗效优于紫杉醇洗脱支架和佐他莫斯洗脱支架,但不优于新一代不可降解聚合物涂层DES。综合而言,新一代不可降解聚合物涂层支架安全性和疗效综合性能最优。 第一代不可降解聚合物涂层药物洗脱支架(D

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