Sex steroid hormones

性类固醇激素
  • 文章类型: Journal Article
    性类固醇激素(SSH)是具有多种生理功能的极其通用的分子。除了它们在性发育和生殖中众所周知的作用之外,SSH在人体的几乎每个组织中都发挥着积极的作用,包括口腔。长期以来已经证明牙周组织表达SSH受体,因此对SSH的存在有反应。有趣的是,SSH不仅与牙周组织相互作用,而且与口腔中的其他组织如牙釉质相互作用,纸浆,牙骨质,口腔粘膜,和唾液腺.关于这些受体可能的生理功能及其在维护口腔健康中的作用的问题,仍然没有答案。这项范围审查的目的是收集和总结有关SSH在人类口腔生理过程中的作用的所有可用证据。进行了两次全面的文献检索。根据标题筛选和选择参考文献,根据我们的纳入标准,摘要和全文。两次搜索都产生了18,992个结果,其中包括73个结果。结果分为四类:(1)牙周组织;(2)牙齿结构;(3)粘膜;(4)唾液腺。这些组织与孕激素的相互作用,概述了雄激素和雌激素。性类固醇激素是口服体内平衡中被忽视的基本因素。它们在牙周组织的发育和功能中起着重要作用,牙科结构,粘膜和唾液腺。牙医和医疗保健提供者在评估和治疗口腔健康状况时应考虑这些激素因素。
    Sex steroid hormones (SSH) are extremely versatile molecules with a myriad of physiological functions. Next to their well-known role in sexual development and reproduction, SSH play active roles in practically every tissue in the human body, including the oral cavity. It has long been demonstrated that periodontal tissues express SSH receptors and therefore are responsive to the presence of SSH. Interestingly, SSH not only interact with the periodontal tissues but also with other tissues in the oral cavity such as dental enamel, pulp, cementum, oral mucosa, and salivary glands. Questions concerning the possible physiological functions of these receptors and their role in maintenance of oral health, remain unanswered. The purpose of this scoping review was to gather and summarize all the available evidence on the role of SSH in physiological processes in the oral cavity in humans. Two comprehensive literature searches were performed. References were screened and selected based on title, abstract and full text according to our inclusion criteria. Both searches yielded 18,992 results of which 73 were included. Results were divided into four categories: (1) Periodontium; (2) Dental structure; (3) Mucosa; and (4) Salivary glands. The interaction of these tissues with progestagens, androgens and estrogens are summarized. Sex steroid hormones are an overlooked yet fundamental factor in oral homeostasis. They play important roles in the development and function of the periodontium, dental structure, mucosa and salivary glands. Dentists and healthcare providers should consider these hormonal factors when assessing and treating oral health conditions.
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  • 文章类型: Journal Article
    创伤性脊髓损伤(SCI)的主要机制包括由于能量传递到脊髓而引起的初始机械性创伤,随后的畸形,和持续压缩。损伤的次要机制,其中包括在最初的创伤后保持完好无损的结构,触发微血管灌注的改变,自由基和神经递质的解放,脂质过氧化,离子浓度的变化,以及随之而来的细胞坏死和凋亡。SCI治疗的研究寻求开发早期治疗干预措施,以减轻这些病理生理机制的影响。临床和实验证据已经证明了创伤性脑损伤和SCI后给予性类固醇激素的治疗益处。雌二醇的给药,黄体酮,睾酮与神经保护作用有关,更好的神经恢复,SCI后死亡率降低。这篇综述评估了支持激素相关神经保护对SCI的证据以及动物模型中可能的潜在机制。由于神经保护与信号通路相关,观察到这些激素对星形胶质细胞和小胶质细胞的影响,调节炎症反应,脑血流量,和新陈代谢,介导谷氨酸兴奋毒性,和它们的抗氧化作用。根据目前的证据,在SCI患者的临床治疗中,分析性类固醇激素治疗的益处至关重要。
    The primary mechanism of traumatic spinal cord injury (SCI) comprises the initial mechanical trauma due to the transmission of energy to the spinal cord, subsequent deformity, and persistent compression. The secondary mechanism of injury, which involves structures that remained undamaged after the initial trauma, triggers alterations in microvascular perfusion, the liberation of free radicals and neurotransmitters, lipid peroxidation, alteration in ionic concentrations, and the consequent cell death by necrosis and apoptosis. Research in the treatment of SCI has sought to develop early therapeutic interventions that mitigate the effects of these pathophysiological mechanisms. Clinical and experimental evidence has demonstrated the therapeutic benefits of sex-steroid hormone administration after traumatic brain injury and SCI. The administration of estradiol, progesterone, and testosterone has been associated with neuroprotective effects, better neurological recovery, and decreased mortality after SCI. This review evaluated evidence supporting hormone-related neuroprotection over SCI and the possible underlying mechanisms in animal models. As neuroprotection has been associated with signaling pathways, the effects of these hormones are observed on astrocytes and microglia, modulating the inflammatory response, cerebral blood flow, and metabolism, mediating glutamate excitotoxicity, and their antioxidant effects. Based on the current evidence, it is essential to analyze the benefit of sex steroid hormone therapy in the clinical management of patients with SCI.
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  • 文章类型: Journal Article
    性激素,包括睾酮和雌二醇,在肺部健康和疾病的各个方面发挥重要作用。然而,尽管有一些研究试图将性激素与COPD联系起来,由于样本量小和因果结果不足,其效果仍然有限.本研究旨在基于国家健康与营养调查(NHANES)数据库调查性激素与慢性阻塞性肺疾病(COPD)之间的关系,并通过两个样本孟德尔随机化(MR)评估因果关系。
    来自NHANES2013-2016年的数据被纳入横断面研究。性激素与COPD之间的关系通过多变量逻辑回归进行评估。性别分层分析,我们进行了亚组分析和交互作用检验,以进一步评估相关性.对于MR分析,数据来自全基因组关联研究和FinnGen数据集。逆方差加权(IVW)方法,以及其他四种方法,在分析中得到了应用。进一步进行敏感性分析以评估多效性和异质性的存在。
    7,617名符合条件的参与者参加了横断面分析。在协变量调整后,睾酮-COPD(OR0.770,95%CI0.626,0.948,p=0.018)和雌二醇-COPD(OR0.794,95%CI0.688,0.915,p=0.005)的关系均呈负相关。然而,IVW-MR分析的结果表明,在睾酮-COPD(OR0.83,95%CI0.53,1.29,p=0.407)或雌二醇-COPD(OR0.74,95%CI0.23,2.38,p=0.616)关系中未观察到因果关系,这也得到了其他四种方法的支持(所有p值>0.05)。
    尽管在性激素和COPD之间观察到显著的负相关性,MR分析结果不支持这种关系的因果关系.我们的研究表明,性激素可能通过潜在的协变量间接而不是直接影响COPD的发展。这需要进一步调查。
    UNASSIGNED: Sex steroid hormones, including testosterone and estradiol, play significant roles in various aspects of pulmonary health and diseases. However, although there were a few studies trying to link sex hormones with COPD, their effect remained limited due to small sample size and insufficient causal results. This study aims to investigate the association between sex hormones and chronic obstructive pulmonary disease (COPD) based on the National Health and Nutrition Examination Survey (NHANES) database and evaluate causality via a two-sample Mendelian randomization (MR).
    UNASSIGNED: Data from NHANES 2013-2016 were enrolled for the cross-sectional study. The association between sex hormones and COPD was evaluated via multivariable logistic regression. Sex-stratified analysis, subgroup analyses and interaction tests were performed to further evaluate the correlation. For MR analysis, data were collected from genome-wide association studies and FinnGen datasets. The inverse-variance-weighted (IVW) approach, along with four other approaches, was applied in the analysis. Further sensitivity analysis was conducted to assess the existence of pleiotropy and heterogeneity.
    UNASSIGNED: 7,617 eligible participants were enrolled in the cross-sectional analysis. Negative associations were observed in both testosterone-COPD (OR 0.770, 95% CI 0.626, 0.948, p = 0.018) and estradiol-COPD (OR 0.794, 95% CI 0.688, 0.915, p = 0.005) relationships after covariate adjustments. However, the results from IVW-MR analysis showed that no causal relationship was observed in either the testosterone-COPD (OR 0.83, 95% CI 0.53, 1.29, p = 0.407) or estradiol-COPD (OR 0.74, 95% CI 0.23, 2.38, p = 0.616) relationship, which was also supported by the other four approaches (all p values > 0.05).
    UNASSIGNED: Although a significant negative association was observed between sex hormones and COPD, the results of MR analysis did not support the causality of this relationship. Our study suggested that sex hormones may indirectly rather than directly affect the development of COPD via potential covariates, which warranted further investigations.
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  • 文章类型: Journal Article
    目的:许多合成的内分泌干扰化学物质(EDCs)在环境中普遍存在,并且在孕妇中被高度检测到。这些化学物质可能会破坏母体和/或胎儿的性类固醇激素,这对维持妊娠和胎儿发育至关重要。这里,我们回顾了流行病学文献,研究了产前暴露于与母体和胎儿性类固醇激素相关的常见合成EDC。
    结果:我们使用PubMed进行了文献检索,Scopus,和Embase,最终确定29篇文章进行全面审查。酚类,对羟基苯甲酸酯,持久性有机污染物通常与雄激素呈负相关,雌激素,和黄体酮。邻苯二甲酸酯和过氟烷基和多氟烷基物质倾向于与孕酮呈负相关,而关于雄激素和雌激素的证据是混合的。不一致,但值得注意的是,观察到胎儿性别和暴露时间/结局的差异.总的来说,文献表明,EDC可能会破坏母体和胎儿的性类固醇活性,虽然调查结果好坏参半。鉴于无处不在,这些合成化学物质的大量生产以及性激素在妊娠期间发挥的关键功能,额外的研究是必要的。
    OBJECTIVE: Many synthetic endocrine-disrupting chemicals (EDCs) are ubiquitous in the environment and highly detected among pregnant people. These chemicals may disrupt maternal and/or fetal sex steroid hormones, which are critical to pregnancy maintenance and fetal development. Here, we review the epidemiological literature examining prenatal exposure to common synthetic EDCs in relation to maternal and fetal sex steroid hormones.
    RESULTS: We performed a literature search using PubMed, SCOPUS, and Embase, ultimately identifying 29 articles for full review. Phenols, parabens, and persistent organic pollutants generally showed inverse associations with androgens, estrogens, and progesterone. Phthalates and per-and polyfluoroalkyl substances tended to be inversely associated with progesterone, while evidence regarding androgens and estrogens was mixed. Inconsistent, but noteworthy, differences by fetal sex and timing of exposure/outcome were observed. Overall, the literature suggests EDCs may disrupt maternal and fetal sex steroid activity, though findings are mixed. Given the pervasive, high-volume production of these synthetic chemicals and the critical functions sex steroid hormones play during gestation, additional research is warranted.
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  • 文章类型: Journal Article
    背景:性激素在月经周期中波动,这会影响女性的力量和姿势稳定性,并导致受伤和跌倒的风险。这些激素可以通过运动来调节,以影响女性的整体健康。
    目的:研究运动对闭经女性性激素的影响。
    方法:本综述是根据拉合尔系统评价和荟萃分析(PRISMA)指南的首选报告项目进行的,巴基斯坦。使用这些数据库/搜索引擎(PubMed,WebofScience和谷歌学者,科技中心)。还包括随机对照试验以及单组实验研究。将所有类型的运动与对照组中的无运动进行比较。Cochrane偏差风险评估工具对文章进行了评估和筛选。然后分析数据。主要结果是雌激素水平,黄体酮和睾酮。
    结果:共纳入11项研究(5项随机对照试验和6项准实验研究)。运动对游离雌二醇浓度和血清孕酮水平的影响不显着[p=0.37(SMD=0.33,95%CI=0.14至0.74,I2=0%)和p=0.84(S。D=-0.65,C.I=-6.92至5.62,I2=94%)],然而,对睾酮水平的影响是显著的[p值<0.00001(M。D=0.89,95%C.I=-2.16至3.95,I2=94%)]。
    结论:应进行一项盲法随机对照试验,其中女性应采用结构化方法并进行热身,冷静和休息间隔。
    背景:系统评价前瞻性地在PROSPERO上注册,注册号为CRD42023473767。
    BACKGROUND: The sex steroid hormones fluctuate during the menstrual cycle, which affects the strength and postural stability of females and leads to injuries and risk of falls. These hormones may be modulated by exercise to impact the overall health of females.
    OBJECTIVE: To determine the effects of exercise on sex steroid hormones in eumenorrheic females.
    METHODS: This review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) guidelines in Lahore, Pakistan. The full-length articles were searched using these databases/search engines (PubMed, Web of Science and Google Scholar, Sci-Hub). Randomized controlled trials along with single group experimental studies were also included. All types of exercises were compared with no exercise in the control group. The Cochrane Risk of Bias assessment tool assessed and screened the articles. The data were then analyzed. The primary outcomes were the levels of estrogen, progesterone and testosterone.
    RESULTS: Eleven studies were included (5 randomized controlled trials and 6 quasi-experimental studies). The effects of exercise on free estradiol concentration and serum progesterone level were not significant [p = 0.37 (SMD = 0.33, 95% CI = 0.14 to 0.74, I2 = 0%) and p = 0.84 (S.D= -0.65, C.I= -6.92 to 5.62, I2 = 94%)] respectively, whereas, the effects on testosterone levels were significant [p value < 0.00001 (M.D = 0.89, 95% C.I= -2.16 to 3.95, I2 = 94%)].
    CONCLUSIONS: A blinded randomized controlled trial should be conducted in which a structured approach should be followed by women along with warm-ups, cool down and rest intervals.
    BACKGROUND: The systematic review was registered prospectively on PROSPERO with registration number CRD42023473767.
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  • 文章类型: Journal Article
    背景:香烟暴露与睡眠障碍和抑郁的剂量反应和非线性关系是有保证的,性激素在这种关联中的潜在机制仍不清楚。
    方法:香烟暴露,睡眠困难,通过标准问卷评估抑郁症,从国家健康和营养检查调查(NHANES)中确定了9900名成年人的可替宁和性类固醇激素水平。多元线性回归,逻辑回归,和调解模型被用来评估吸烟之间的关联,性类固醇激素,睡眠困难,和抑郁症。
    结果:以从不吸烟者为参考,目前吸烟者睡眠障碍(OR=1.931,95%CI:1.680,2.219)和抑郁(OR=2.525,95%CI:1.936,3.293)以及睾酮水平(β=0.083,95%CI:0.028,0.140)的患病率较高。每天吸烟和吸烟的包年与睡眠障碍和抑郁症的患病率以及睾丸激素水平呈正相关(Ptrend<0.05)。受限三次样条模型显示可替宁与睡眠困难的线性关系,抑郁症,和睾丸激素。女性每天吸烟与睡眠障碍和抑郁的正相关大于男性(P修饰<0.05)。然而,在可替宁与睡眠障碍或抑郁的相关性中未观察到性激素的潜在作用(P>0.05)。
    结论:吸烟可能引起性激素紊乱,增加睡眠问题和抑郁症状的风险,戒烟可能会降低此类并发症的风险。
    BACKGROUND: Dose-response and nonlinear relationships of cigarette exposure with sleep disturbances and depression are warranted, and the potential mechanism of sex hormones in such associations remains unclear.
    METHODS: Cigarette exposure, trouble sleeping, and depression were assessed by standard questionnaires, and the levels of cotinine and sex steroid hormones were determined among 9900 adults from the National Health and Nutrition Examination Survey (NHANES). Multiple linear regression, logistic regression, and mediation models were conducted to evaluate the associations between smoking, sex steroid hormones, trouble sleeping, and depression.
    RESULTS: With never smokers as a reference, current smokers had a higher prevalence of trouble sleeping (OR = 1.931, 95% CI: 1.680, 2.219) and depression (OR = 2.525, 95% CI: 1.936, 3.293) as well as testosterone level (β = 0.083, 95% CI: 0.028, 0.140). Pack-years of smoking and cigarettes per day were positively associated with the prevalence of trouble sleeping and depression as well as testosterone level (Ptrend <0.05). The restricted cubic spline model showed linear relationships of cotinine with trouble sleeping, depression, and testosterone. The positive associations of cigarettes per day with trouble sleeping and depression were greater in females than that in males (Pmodification <0.05). However, the potential role of sex hormones was not observed in the association of cotinine with trouble sleeping or depression (Pmediation >0.05).
    CONCLUSIONS: Smoking may induce sex hormone disturbance and increase the risk of sleep problems and depression symptoms, and ceasing smoking may reduce the risk of such complications.
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  • 文章类型: Journal Article
    全身炎症指数(SII),性类固醇激素,膳食抗氧化剂(DA),痛风尚未确定。我们的目标是开发一种可靠且可解释的机器学习(ML)模型,该模型将SII链接在一起,性类固醇激素,和DA到痛风鉴定。
    我们用来研究SII之间关系的数据集,性类固醇激素,DA,痛风来自国家健康和营养检查调查(NHANES)。开发了六个ML模型来通过SII识别痛风,性类固醇激素,和DA。总结了每个模型的七个性能判别特征,选择整体性能最佳的极限梯度提升(XGBoost)模型来识别痛风。我们使用Shapley加法扩张(SHAP)方法来解释XGBoost模型及其决策过程。
    对20,146名参与者进行的初步调查导致8,550名参与者被纳入研究。选择与SII相关的性能最佳的XGBoost模型,性类固醇激素,与DA鉴别痛风(男性:AUC:0.795,95%CI:0.746-0.843,准确率:98.7%;女性:AUC:0.822,95%CI:0.754-0.883,准确率:99.2%)。在男性群体中,SHAP值显示叶黄素+玉米黄质(LZ)的特征值较低,维生素C(VitC),番茄红素,锌,总睾酮(TT),维生素E(VIE),和维生素A(VitA),对模型产出的正向影响越大。在女性群体中,SHAP值显示E2、锌、番茄红素,LZ,TT,硒对模型输出有较大的正向影响。
    可解释的XGBoost模型证明了准确性,效率,以及识别SII之间关联的鲁棒性,性类固醇激素,DA,参与者的痛风。男性TT降低和女性E2降低可能与痛风有关。增加DA摄入量和减少SII可能会降低痛风的潜在风险。
    UNASSIGNED: The relationship between systemic inflammatory index (SII), sex steroid hormones, dietary antioxidants (DA), and gout has not been determined. We aim to develop a reliable and interpretable machine learning (ML) model that links SII, sex steroid hormones, and DA to gout identification.
    UNASSIGNED: The dataset we used to study the relationship between SII, sex steroid hormones, DA, and gout was from the National Health and Nutrition Examination Survey (NHANES). Six ML models were developed to identify gout by SII, sex steroid hormones, and DA. The seven performance discriminative features of each model were summarized, and the eXtreme Gradient Boosting (XGBoost) model with the best overall performance was selected to identify gout. We used the SHapley Additive exPlanation (SHAP) method to explain the XGBoost model and its decision-making process.
    UNASSIGNED: An initial survey of 20,146 participants resulted in 8,550 being included in the study. Selecting the best performing XGBoost model associated with SII, sex steroid hormones, and DA to identify gout (male: AUC: 0.795, 95% CI: 0.746- 0.843, accuracy: 98.7%; female: AUC: 0.822, 95% CI: 0.754- 0.883, accuracy: 99.2%). In the male group, The SHAP values showed that the lower feature values of lutein + zeaxanthin (LZ), vitamin C (VitC), lycopene, zinc, total testosterone (TT), vitamin E (VitE), and vitamin A (VitA), the greater the positive effect on the model output. In the female group, SHAP values showed that lower feature values of E2, zinc, lycopene, LZ, TT, and selenium had a greater positive effect on model output.
    UNASSIGNED: The interpretable XGBoost model demonstrated accuracy, efficiency, and robustness in identifying associations between SII, sex steroid hormones, DA, and gout in participants. Decreased TT in males and decreased E2 in females may be associated with gout, and increased DA intake and decreased SII may reduce the potential risk of gout.
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  • 文章类型: Journal Article
    性类固醇激素是癫痫女性(WWE)中出现的抑郁症的重要生物标志物,具有很好的预后潜力和治疗终点。因此,这项研究旨在探索性类固醇激素之间的关联,WWE中的抗癫痫药物(ASM)和抑郁症。
    使用基线问卷从一百一十二(112)WWE和50个年龄匹配的健康对照中获得社会人口统计学和临床特征。癫痫的诊断和脑电图(EEG)描述基于2017年国际抗癫痫联盟(ILAE)标准。在黄体期(LP)和卵泡期(FP)期间从病例和对照收集血液样品。Zung抑郁自评量表(ZSRDS)用于评估抑郁症。
    WWE中抑郁症的患病率为18.8%,与正规教育水平之间存在显著差异(p0.000),年龄(p0.000),病例和对照组的平均ZSRDS(p0.000)。在高睾酮方面,病例和对照组之间的激素水平存在统计学差异[3.28±9.99vs.0.31±0.30;p0.037],较低的FP催乳素[16.37±20.14vs.17.20±7.44;p0.778],和较低的LP催乳素[15.74±18.22vs.17.67±7.27;p0.473]。睾酮(p0.024),FP卵泡刺激素(FSH)(p0.009),FP雌二醇(p0.006),LPFSH(p0.031),LP孕酮(p0.023),LP催乳素(p0.000)与抑郁症有关。然而,只有催乳素(p0.042)和睾酮(p0.000)可预测WWE中的抑郁。
    平均抑郁评分较高,与对照组相比,病例中的催乳素水平较低,睾酮水平较高。此外,与左乙拉西坦(LEV)组相比,卡马西平(CBZ)组催乳素水平较低,睾酮水平较高.
    UNASSIGNED: Sex steroid hormones are emerging significant biomarkers of depression among Women with Epilepsy (WWE) with promising prognostic potential and therapeutic end point. Therefore, the study is aimed at exploring the association between sex steroids hormones, Anti-seizure Medication (ASM) and depression among WWE.
    UNASSIGNED: A baseline questionnaire was used to obtain socio-demographics and clinical characteristic from one hundred and twelve (112) WWE and 50 age matched healthy control. The diagnosis of epilepsy and Electroencephalography (EEG) description was based on 2017 International League Against Epilepsy (ILAE) criteria. Blood samples were collected from cases and control during Luteal Phase (LP) and Follicular Phase (FP). The Zung Self-Rating Depression Scale (ZSRDS) was used to assess depression.
    UNASSIGNED: The prevalence of depression among WWE is 18.8%, with a significant difference between the level of formal education (p0.000), age (p0.000), and mean ZSRDS (p0.000) among cases and control. There is a statistical difference in hormonal levels between cases and control with regards to higher testosterone [3.28 ± 9.99 vs. 0.31 ± 0.30; p0.037], lower FP prolactin [16.37 ± 20.14 vs. 17.20 ± 7.44; p0.778], and lower LP prolactin [15.74 ± 18.22 vs. 17.67 ± 7.27; p0.473]. Testosterone (p0.024), FP Follicle Stimulating Hormone (FSH) (p0.009), FP Estradiol (p0.006), LP FSH (p0.031), LP Progesterone (p0.023), and LP Prolactin (p0.000) were associated with depression. However, only prolactin (p0.042) and testosterone (p0.000) predicts depression among WWE.
    UNASSIGNED: There was higher mean depression score, lower prolactin and higher testosterone level among cases compared to control. Furthermore, there was lower prolactin and higher testosterone level in Carbamazepine (CBZ) group compared to Levetiracetam (LEV) groups.
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  • 文章类型: Journal Article
    甲状腺癌更常见于女性,是育龄妇女中第三大最常见的癌症。我们在芬兰产妇队列中进行了一项巢式病例对照研究,以评估诊断前的性类固醇和甲状腺功能标志物与随后的母体乳头状甲状腺癌的关系。病例(n=605)为18-44岁的女性,提供了早孕(<20周妊娠)血液样本,并在11年后被诊断出患有甲状腺乳头状癌。对照(n=1185)与胎龄2:1的病例相匹配,母亲的年龄,并在抽血时约会。血清甲状腺过氧化物酶抗体(TPO-Ab)的关联的赔率比(ORs),甲状腺球蛋白抗体(Tg-Ab),促甲状腺激素(TSH),游离甲状腺素(fT4),游离三碘甲状腺原氨酸(fT3),黄体酮,和雌二醇与甲状腺乳头状癌的估计使用条件逻辑回归。TPO-Ab和Tg-Ab阳性(对照组中>95百分位数)与甲状腺乳头状癌的几率增加超过3倍(OR=3.32,95%置信区间[CI]2.33-4.72)和2倍(OR=2.03,95%CI1.41-2.93)相关,分别。自从抽血以来,这些关联在时间上是相似的,奇偶校验,胎龄,吸烟状况,以及诊断时的年龄和阶段。在不包括TPO-Ab或Tg-Ab阳性的模型中,TPO-Ab(四分位数4vs.1:OR=1.66,95%CI1.17-2.37,p趋势=.002)和Tg-Ab(四分位数4与1:OR=1.74,95%CI1.22-2.49,p趋势=0.01)水平与甲状腺乳头状癌呈正相关。没有观察到雌二醇的关联,黄体酮,TSH,fT3,或fT4整体。我们的结果表明,妊娠早期的甲状腺自身免疫可能会增加母体乳头状甲状腺癌的风险。
    Thyroid cancer more commonly affects women than men and is the third most frequently diagnosed cancer among women of reproductive age. We conducted a nested case-control study within the Finnish Maternity Cohort to evaluate pre-diagnostic sex steroid and thyroid function markers in relation to subsequent maternal papillary thyroid cancer. Cases (n = 605) were women ages 18-44 years, who provided an early-pregnancy (<20 weeks gestation) blood sample and were diagnosed with papillary thyroid cancer up to 11 years afterward. Controls (n = 1185) were matched to cases 2:1 by gestational age, mother\'s age, and date at blood draw. Odds ratios (ORs) for the associations of serum thyroid peroxidase antibodies (TPO-Ab), thyroglobulin antibodies (Tg-Ab), thyroid stimulating hormone (TSH), free thyroxine (fT4), free triiodothyronine (fT3), progesterone, and estradiol with papillary thyroid cancer were estimated using conditional logistic regression. TPO-Ab and Tg-Ab positivity (>95th percentile among controls) were associated with more than 3-fold (OR = 3.32, 95% confidence interval [CI] 2.33-4.72) and 2-fold (OR = 2.03, 95% CI 1.41-2.93) increased odds of papillary thyroid cancer, respectively. These associations were similar by time since blood draw, parity, gestational age, smoking status, and age and stage at diagnosis. In models excluding TPO-Ab or Tg-Ab positivity, TPO-Ab (quartile 4 vs. 1: OR = 1.66, 95% CI 1.17-2.37, p-trend = .002) and Tg-Ab (quartile 4 vs. 1: OR = 1.74, 95% CI 1.22-2.49, p-trend = .01) levels were positively associated with papillary thyroid cancer. No associations were observed for estradiol, progesterone, TSH, fT3, or fT4 overall. Our results suggest that thyroid autoimmunity in early pregnancy may increase the risk of maternal papillary thyroid cancer.
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  • 文章类型: Journal Article
    关于心血管疾病(CVD)的风险存在相当大的性别差异,包括动脉高血压,冠状动脉疾病(CAD)和中风,以及慢性肾病。在更年期之前,妇女在很大程度上受到保护免受这些疾病的影响,内源性雌激素产生停止或手术绝经后,风险增加。女性的心血管疾病通常比男性的年龄晚(平均延迟10年)。雌激素产生的停止也会影响新陈代谢,增加患肥胖症和糖尿病的风险。在中年患者中,女性高血压比男性发展得更早、更快,吸烟会增加女性的心血管风险,而不是男性。不仅雌激素会影响女性的心血管健康,并在绝经前发挥保护作用:其他性激素,例如孕激素和雄激素激素,会产生复杂的平衡,从而使女性的心脏和血管功能与男性相比有所差异。雌激素通过促进一氧化氮和前列环素等血管舒张因子的释放来改善心外膜冠状动脉和冠状动脉微脉管系统。与男性相比,这似乎是女性冠状血管扩张的主要机制之一。雌激素也是强大的炎症抑制剂,部分解释了它们对心血管疾病和慢性肾脏疾病的保护作用。新出现的证据表明,性染色体在形成心血管风险方面也起着重要作用。内源性雌激素赋予的心血管保护可以通过安全的外源性雌激素和孕激素来延长。特别是在绝经后早期使用生物相同激素并开始治疗的女性。
    There are considerable sex differences regarding the risk of cardiovascular disease (CVD), including arterial hypertension, coronary artery disease (CAD) and stroke, as well as chronic renal disease. Women are largely protected from these conditions prior to menopause, and the risk increases following cessation of endogenous estrogen production or after surgical menopause. Cardiovascular diseases in women generally begin to occur at a later age than in men (on average with a delay of 10 years). Cessation of estrogen production also impacts metabolism, increasing the risk of developing obesity and diabetes. In middle-aged individuals, hypertension develops earlier and faster in women than in men, and smoking increases cardiovascular risk to a greater degree in women than it does in men. It is not only estrogen that affects female cardiovascular health and plays a protective role until menopause: other sex hormones such as progesterone and androgen hormones generate a complex balance that differentiates heart and blood vessel function in women compared to men. Estrogens improve vasodilation of epicardial coronary arteries and the coronary microvasculature by augmenting the release of vasodilating factors such as nitric oxide and prostacyclin, which are mechanisms of coronary vasodilatation that are more pronounced in women compared to men. Estrogens are also powerful inhibitors of inflammation, which in part explains their protective effects on CVD and chronic renal disease. Emerging evidence suggests that sex chromosomes also play a significant role in shaping cardiovascular risk. The cardiovascular protection conferred by endogenous estrogens may be extended by hormone therapy, especially using bioidentical hormones and starting treatment early after menopause.
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