В обзоре освещается роль эндо- и экзогенных эстрогенов и андрогенов в генезе кардиометаболических расстройств у женщин в постменопаузе и роль менопаузальной гормонотерапии в их профилактике. Ключевые слова: постменопауза, эстрогены, андрогены, менопаузальная гормонотерапия, кардиометаболические расстройства.
________________________________________________
The review highlights the role of endo- and exogenous estrogens and androgens in the genesis of cardiometabolic disorders in postmenopausal women and the role of menopausal hormone therapy in their prevention. Key words: postmenopause, estrogens, androgens, menopausal hormone therapy, cardiometabolic disorders.
1. North American Menopause Society (2015). The North American Menopause Society statement on continuing use of systemic hormone therapy after age 65. Menopause 2015; 22 (7): 693. http://www.menopause.org/docs/default-source/2015/2015-nams-hormone-therapy-after-age-65.pdf. Accessed August 24, 2015.
2. Менопаузальная гормонотерапия и сохранение здоровья женщин зрелого возраста. Клинические рекомендации: протоколы. Проект (Москва 2015). Климактерий. 2014; 4: 8–31. / Menopauzal'naia gormonoterapiia i sokhranenie zdorov'ia zhenshchin zrelogo vozrasta. Klinicheskie rekomendatsii: protokoly. Proekt (Moskva 2015). Klimakterii. 2014; 4: 8–31. [in Russian]
3. Павлунина Т.О., Шувалова Ю.А., Каминная В.И. и др. Ассоциация классических факторов риска сердечно-сосудистых заболеваний и факторов воспаления с тяжестью коронарного атеросклероза. Соврем. проблемы науки и образования. 2012; 6. URL: www.science-education.ru/106-7993. / Pavlunina T.O., Shuvalova Iu.A., Kaminnaia V.I. i dr. Assotsiatsiia klassicheskikh faktorov riska serdechno-sosudistykh zabolevaniĭ i faktorov vospaleniia s tiazhest'iu koronarnogo ateroskleroza. Sovrem. problemy nauki i obrazovaniia. 2012; 6. URL: www.science-education.ru/106-7993. [in Russian]
4. Segers P, Kips JG, Vermeersch SJ et al. A model expression for the ambulatory arterial stiffness index. J Hypertens 2013; 31 (1): 211–2. DOI: 10.1097/HJH.0b013e32835a927b.
5. NICE guideline 2015. Menopause: diagnosis and management.nice.org.uk/guidance/ng23
6. Vestergaard P, Hermann P, Jensen JE et al. Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int 2012; 23 (4): 1255–65.
7. World population projected to reach 9.6 billion by 2050 with mostgrowth in developing regions, especially Africa, 2013 United Nationshttp://esa.un.org/unpd/wpp/Documentation/pdf/WPP2012_Press_Release.pdf 26.02.2015
8. De Villiers TJ et al. Global Consensus Statement on Menopausal Hormone Therapy. Climacteric 2013; 16: 203–4.
9. Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80: 1429–30.
10. Erickson GF, Magoffin DA, Dyer CA, Hofeditz C. The ovarian androgen producing cells: a review of structure/function relationships. Endocrine Rev 1985; 6: 371–99.
11. Roger VL et аl. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation 2011; 123: 18–209.
12. ACOG Practice Bulletin No. 141: Management ofMenopausal Symptoms. Obstetrics & Gynecology 2014; 123: 202–16.
13. Avis NE, Crawford SL, Greendale G et al; the Study ofWomen’s Health Across the Nation (SWAN). Duration of menopausal vasomotor symptoms over the menopause transition [published online ahead of print February 16, 2015]. JAMA Intern Med doi:10.1001/jamainternmed.2014.8063
14. Kenemans P, Bundred NJ, Foidart JM et al. Safety and efficacy of tibolone in breast-cancer patients with vasomotor symptoms: a double-blind, randomised, non-inferiority trial. Lancet Oncol 2009; 10 (2): 135–46.
15. International Consultation on Sexual Medicine Organized under the auspices of the International Consultation on Urological Diseases (ICUD) and the International Society for Sexual Medicine (ISSM) July 10–13, 2009. ICSM2009_finalprogram_website.pdf
16. Dinger J, Heinemann K (Berlin Center for Epidemiology and Health Research EURAS-HRT The Safety of Oral Hormone Replacement Therapy: Final Results from the EURAS-HRT Study. 13th World Congress on Menopause, Rome, 8-11 June 2011
17. Sutton-Tyrrell K, Wildman R, Matthews K et al. Sex hormone-binding globulin and the free androgen index are related to cardiovascular risk factors in multiethnic premenopausal and perimenopausal women enrolled in the Study of Women Across the Nation (SWAN). Circulation 2005; 111: 1242–9.
18. Santoro N, Torrens J, Crawford S et al. Correlates of circulating androgens in mid-life women: the Study of Women’s Health Across the Nation. J Clin Endocrinol Metab 2005; 90: 4836–45.
19. Janssen I, Powell L, Crawford S et al. Menopause and the metabolic syndrome. Arch Intern Med 2008; 168: 1568–75.
20. Fauser BCJM, Tarlatzis BC, Rebar RW et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group Fertil Steril 2011; 97: 28–38.
21. Jones GL, Hall JM, Balen AH, Ledger WL. Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review. Hum Reprod Update 2008; 14: 15–25.
22. Franciscis PD, Mainini G, Labriola D et al. Low-dose estrogen and drospirenone combination: effects on metabolism and endothelial function in postmenopausal women with metabolic syndrome. Clin Exp Obstet Gynecol 2013; 40 (2): 233–5.
23. Woodis CB, McLendon AN, Muzyk AJ. Testosterone Supplementation for Hypoactive Sexual Desire Disorder in Women. Pharmacotherapy 2012; 32 (1): 38–53.
24. Rizzo MR, Leo S, De Franciscis P et al. Short-term effects of low-dose estrogen/drospirenone vs low-dose estrogen/dydrogesterone on glycemic fluctuations in postmenopausal women with metabolic syndrome. Age (Dordr) 2014; 36 (1): 265–74.
25. Janssen I, Powel LH, Kazlauskaite R et al. Testosterone and Visceral Fat in Midlife Women: The Study of Women’s Health Across the Nation (SWAN) Fat Patterning Study. Obesity 2010; 18 (3): 604–10.
26. Crandall CJ, Aragaki A, Cauley JA et al. Associations of menopausal vasomotor symptoms with fracture incidence. J Clin Endocrinol Metab 2015; 100: 524–34.
27. Lambrinoudaki I, Georgiopoulos GA, Athanasouli F et al. Free androgen index as a determinant of arterial stiffness in menopause: a mediation analysis. Menopause 2017; 24 (6): 635–44.
28. Caprio M, Antelmi A, Chetrite G et al. Antiadipogenic effects of the mineralocorticoid receptor antagonist drospirenone: potential implications for the treatment of metabolic syndrome. Endocrinology 2011; 152 (1): 113–25.
29. Byrd JB, Brook RD. A critical review of the evidence supporting aldosterone in the etiology and its blockade in the treatment of obesity-associated hypertension. J Hum Hypertens 2014; 28: 3–9.
30. Engeli S, Bohnke J, Gorzelniak K et al. Weight loss and the renin-angiotensinaldosterone system. Hypertension 2005; 45: 356–62.
31. Dinger J, Bardenheuer K, Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric 2016; 19 (4): 349–56.
32. Salpeter SR, Walsh JM, Ormiston TM et al. Meta-analysis:effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes Metab 2006; 8: 538–54.
33. Xu Y, Lin J, Wang S et al. Combined estrogen replacement therapy on metabolic control in postmenopausal women with diabetes mellitus. Kaohsiung J Med Soc 2014; 30: 350–61.
34. Чазова И.Е., Ощепкова Е.В. Опыт борьбы с сердечно-сосудистыми заболеваниями в России. Аналитический вестн. 2015; 44 (597). / Chazova I.E., Oshchepkova E.V. Opyt bor'by s serdechno-sosudistymi zabolevaniiami v Rossii. Analiticheskii vestn. 2015; 44 (597). [in Russian]
35. Otto C, Fuchs I, Altmann H, Klewer M, Walter A, Prelle K, et al. Comparative analysis of the uterine and mammary gland effects of drospirenone and medroxyprogesterone acetate. Endocrinology. 2008;149(8):3952-9.
________________________________________________
1. North American Menopause Society (2015). The North American Menopause Society statement on continuing use of systemic hormone therapy after age 65. Menopause 2015; 22 (7): 693. http://www.menopause.org/docs/default-source/2015/2015-nams-hormone-therapy-after-age-65.pdf. Accessed August 24, 2015.
2. Menopauzal'naia gormonoterapiia i sokhranenie zdorov'ia zhenshchin zrelogo vozrasta. Klinicheskie rekomendatsii: protokoly. Proekt (Moskva 2015). Klimakterii. 2014; 4: 8–31. [in Russian]
3. Pavlunina T.O., Shuvalova Iu.A., Kaminnaia V.I. i dr. Assotsiatsiia klassicheskikh faktorov riska serdechno-sosudistykh zabolevaniĭ i faktorov vospaleniia s tiazhest'iu koronarnogo ateroskleroza. Sovrem. problemy nauki i obrazovaniia. 2012; 6. URL: www.science-education.ru/106-7993. [in Russian]
4. Segers P, Kips JG, Vermeersch SJ et al. A model expression for the ambulatory arterial stiffness index. J Hypertens 2013; 31 (1): 211–2. DOI: 10.1097/HJH.0b013e32835a927b.
5. NICE guideline 2015. Menopause: diagnosis and management.nice.org.uk/guidance/ng23
6. Vestergaard P, Hermann P, Jensen JE et al. Effects of paracetamol, non-steroidal anti-inflammatory drugs, acetylsalicylic acid, and opioids on bone mineral density and risk of fracture: results of the Danish Osteoporosis Prevention Study (DOPS). Osteoporos Int 2012; 23 (4): 1255–65.
7. World population projected to reach 9.6 billion by 2050 with mostgrowth in developing regions, especially Africa, 2013 United Nationshttp://esa.un.org/unpd/wpp/Documentation/pdf/WPP2012_Press_Release.pdf 26.02.2015
8. De Villiers TJ et al. Global Consensus Statement on Menopausal Hormone Therapy. Climacteric 2013; 16: 203–4.
9. Zumoff B, Strain GW, Miller LK, Rosner W. Twenty-four-hour mean plasma testosterone concentration declines with age in normal premenopausal women. J Clin Endocrinol Metab 1995; 80: 1429–30.
10. Erickson GF, Magoffin DA, Dyer CA, Hofeditz C. The ovarian androgen producing cells: a review of structure/function relationships. Endocrine Rev 1985; 6: 371–99.
11. Roger VL et аl. on behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics—2011 update: a report from the American Heart Association. Circulation 2011; 123: 18–209.
12. ACOG Practice Bulletin No. 141: Management ofMenopausal Symptoms. Obstetrics & Gynecology 2014; 123: 202–16.
13. Avis NE, Crawford SL, Greendale G et al; the Study ofWomen’s Health Across the Nation (SWAN). Duration of menopausal vasomotor symptoms over the menopause transition [published online ahead of print February 16, 2015]. JAMA Intern Med doi:10.1001/jamainternmed.2014.8063
14. Kenemans P, Bundred NJ, Foidart JM et al. Safety and efficacy of tibolone in breast-cancer patients with vasomotor symptoms: a double-blind, randomised, non-inferiority trial. Lancet Oncol 2009; 10 (2): 135–46.
15. International Consultation on Sexual Medicine Organized under the auspices of the International Consultation on Urological Diseases (ICUD) and the International Society for Sexual Medicine (ISSM) July 10–13, 2009. ICSM2009_finalprogram_website.pdf
16. Dinger J, Heinemann K (Berlin Center for Epidemiology and Health Research EURAS-HRT The Safety of Oral Hormone Replacement Therapy: Final Results from the EURAS-HRT Study. 13th World Congress on Menopause, Rome, 8-11 June 2011
17. Sutton-Tyrrell K, Wildman R, Matthews K et al. Sex hormone-binding globulin and the free androgen index are related to cardiovascular risk factors in multiethnic premenopausal and perimenopausal women enrolled in the Study of Women Across the Nation (SWAN). Circulation 2005; 111: 1242–9.
18. Santoro N, Torrens J, Crawford S et al. Correlates of circulating androgens in mid-life women: the Study of Women’s Health Across the Nation. J Clin Endocrinol Metab 2005; 90: 4836–45.
19. Janssen I, Powell L, Crawford S et al. Menopause and the metabolic syndrome. Arch Intern Med 2008; 168: 1568–75.
20. Fauser BCJM, Tarlatzis BC, Rebar RW et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group Fertil Steril 2011; 97: 28–38.
21. Jones GL, Hall JM, Balen AH, Ledger WL. Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review. Hum Reprod Update 2008; 14: 15–25.
22. Franciscis PD, Mainini G, Labriola D et al. Low-dose estrogen and drospirenone combination: effects on metabolism and endothelial function in postmenopausal women with metabolic syndrome. Clin Exp Obstet Gynecol 2013; 40 (2): 233–5.
23. Woodis CB, McLendon AN, Muzyk AJ. Testosterone Supplementation for Hypoactive Sexual Desire Disorder in Women. Pharmacotherapy 2012; 32 (1): 38–53.
24. Rizzo MR, Leo S, De Franciscis P et al. Short-term effects of low-dose estrogen/drospirenone vs low-dose estrogen/dydrogesterone on glycemic fluctuations in postmenopausal women with metabolic syndrome. Age (Dordr) 2014; 36 (1): 265–74.
25. Janssen I, Powel LH, Kazlauskaite R et al. Testosterone and Visceral Fat in Midlife Women: The Study of Women’s Health Across the Nation (SWAN) Fat Patterning Study. Obesity 2010; 18 (3): 604–10.
26. Crandall CJ, Aragaki A, Cauley JA et al. Associations of menopausal vasomotor symptoms with fracture incidence. J Clin Endocrinol Metab 2015; 100: 524–34.
27. Lambrinoudaki I, Georgiopoulos GA, Athanasouli F et al. Free androgen index as a determinant of arterial stiffness in menopause: a mediation analysis. Menopause 2017; 24 (6): 635–44.
28. Caprio M, Antelmi A, Chetrite G et al. Antiadipogenic effects of the mineralocorticoid receptor antagonist drospirenone: potential implications for the treatment of metabolic syndrome. Endocrinology 2011; 152 (1): 113–25.
29. Byrd JB, Brook RD. A critical review of the evidence supporting aldosterone in the etiology and its blockade in the treatment of obesity-associated hypertension. J Hum Hypertens 2014; 28: 3–9.
30. Engeli S, Bohnke J, Gorzelniak K et al. Weight loss and the renin-angiotensinaldosterone system. Hypertension 2005; 45: 356–62.
31. Dinger J, Bardenheuer K, Heinemann K. Drospirenone plus estradiol and the risk of serious cardiovascular events in postmenopausal women. Climacteric 2016; 19 (4): 349–56.
32. Salpeter SR, Walsh JM, Ormiston TM et al. Meta-analysis:effect of hormone-replacement therapy on components of the metabolic syndrome in postmenopausal women. Diabetes Obes Metab 2006; 8: 538–54.
33. Xu Y, Lin J, Wang S et al. Combined estrogen replacement therapy on metabolic control in postmenopausal women with diabetes mellitus. Kaohsiung J Med Soc 2014; 30: 350–61.
34. Chazova I.E., Oshchepkova E.V. Opyt bor'by s serdechno-sosudistymi zabolevaniiami v Rossii. Analiticheskii vestn. 2015; 44 (597). [in Russian]
35. Otto C, Fuchs I, Altmann H, Klewer M, Walter A, Prelle K, et al. Comparative analysis of the uterine and mammary gland effects of drospirenone and medroxyprogesterone acetate. Endocrinology. 2008;149(8):3952-9.
ГБУЗ МО «Московский областной научно-исследовательский институт акушерства и гинекологии». 101000, Россия, Москва, ул. Покровка, д. 22а
*balanmed@gmail.com
Moscow Regional Scientific Research Institute of Obstetrics and Gynecology. 101000, Russian Federation, Moscow, ul. Pokrovka, d. 22a
*balanmed@gmail.com