Alzheimer's & Dementia:雌激素和痴呆症的关系:一项全国性的基于人口的研究

2021-08-01 haibei MedSci原创

最近,研究人员在一项病例对照研究中评估了阴道雌二醇片的累积剂量与痴呆症之间的关系,该研究嵌套在一个全国性的丹麦妇女队列中。

痴呆症的特点是认知能力和日常活动的逐渐下降,引起痴呆症的两个主要原因是阿尔茨海默氏病(AD)和血管性痴呆。

已有的一些研究显示,使用全身性激素治疗绝经期血管舒缩症状与绝经后妇女痴呆症的发展呈正相关。这些研究包括妇女健康倡议记忆研究,这是一项随机、双盲、安慰剂对照的临床试验,报告了65岁以上妇女使用激素治疗后患痴呆症的风险增加一倍

此外,也有其他研究显示,激素治疗与痴呆症之间存在负相关或无关联。而关于激素治疗副作用的国际指南(国家健康与护理卓越研究所[NICE]指南)认为,缺乏与痴呆症有关的证据,并呼吁研究人员进行更多的研究。

阴道雌激素是治疗绝经后常见症状的主要方法,如阴道干燥、刺激、排尿困难和尿急尿失禁,并且没有发生过任何严重的不良事件。但是目前,我们对于使用阴道雌二醇与痴呆症风险的剂量依赖性影响知之甚少。

最近,研究人员在一项病例对照研究中评估了阴道雌二醇片的累积剂量与痴呆症之间的关系,该研究嵌套在一个全国性的丹麦妇女队列中,这些妇女在研究开始时年龄在50至60岁,没有使用系统的激素治疗。每个病例与10个女性对照组进行了年龄匹配。

根据阴道雌二醇片的累积剂量,全因痴呆(A)和阿尔茨海默病(B)的危险比(HR)

该研究共有4574名痴呆症患者与45740名对照组进行了匹配。结果显示,累积使用阴道雌二醇片与全因痴呆无关;低剂量(<750微克)的调整危险比为1.02(95%置信区间[CI]为0.89-1.18),中等剂量(750-2000微克)为1.07(0.94-1.21),而高剂量(>2000微克)为0.93(0.84-1.03)。同样,阿尔茨海默病(AD)本身也与使用阴道雌二醇没有关系

因此,该研究结果表明,接触阴道雌二醇片与全因性痴呆或AD本身无关。

 

原始出处:

Nelsan Pourhadi et al. Vaginal estrogen and association with dementia: A nationwide population‐based study. Alzheimer's & Dementia (2021). 

 

 

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1718039, encodeId=56b81e18039f2, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Feb 28 22:10:15 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063231, encodeId=bebc1063231e6, content=😋, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210627/70bba8944cda4a9f961f152438bbef19/2242292829644005a34952b44e2c187e.jpg, createdBy=48fb4806846, createdName=Serendipity lai, createdTime=Sat Oct 23 20:25:51 CST 2021, time=2021-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836277, encodeId=1bd318362e7f3, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Wed Nov 03 17:10:15 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048850, encodeId=fe34104885061, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Sun Aug 01 18:10:15 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004407, encodeId=50e4100440e17, content=棒棒哒, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86e45329161, createdName=148c6444m63暂无昵称, createdTime=Sun Aug 01 15:17:44 CST 2021, time=2021-08-01, status=1, ipAttribution=)]
    2021-10-23 Serendipity lai

    😋

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1718039, encodeId=56b81e18039f2, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Feb 28 22:10:15 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063231, encodeId=bebc1063231e6, content=😋, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210627/70bba8944cda4a9f961f152438bbef19/2242292829644005a34952b44e2c187e.jpg, createdBy=48fb4806846, createdName=Serendipity lai, createdTime=Sat Oct 23 20:25:51 CST 2021, time=2021-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836277, encodeId=1bd318362e7f3, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Wed Nov 03 17:10:15 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048850, encodeId=fe34104885061, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Sun Aug 01 18:10:15 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004407, encodeId=50e4100440e17, content=棒棒哒, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86e45329161, createdName=148c6444m63暂无昵称, createdTime=Sun Aug 01 15:17:44 CST 2021, time=2021-08-01, status=1, ipAttribution=)]
    2021-11-03 Boyinsh
  4. [GetPortalCommentsPageByObjectIdResponse(id=1718039, encodeId=56b81e18039f2, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Feb 28 22:10:15 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063231, encodeId=bebc1063231e6, content=😋, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210627/70bba8944cda4a9f961f152438bbef19/2242292829644005a34952b44e2c187e.jpg, createdBy=48fb4806846, createdName=Serendipity lai, createdTime=Sat Oct 23 20:25:51 CST 2021, time=2021-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836277, encodeId=1bd318362e7f3, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Wed Nov 03 17:10:15 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048850, encodeId=fe34104885061, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Sun Aug 01 18:10:15 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004407, encodeId=50e4100440e17, content=棒棒哒, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86e45329161, createdName=148c6444m63暂无昵称, createdTime=Sun Aug 01 15:17:44 CST 2021, time=2021-08-01, status=1, ipAttribution=)]
    2021-08-01 junJUN

    老年人痴呆何药可用??

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1718039, encodeId=56b81e18039f2, content=<a href='/topic/show?id=8f0658433a' target=_blank style='color:#2F92EE;'>#dementia#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5843, encryptionId=8f0658433a, topicName=dementia)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307e32501717, createdName=linlin2323, createdTime=Mon Feb 28 22:10:15 CST 2022, time=2022-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063231, encodeId=bebc1063231e6, content=😋, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210627/70bba8944cda4a9f961f152438bbef19/2242292829644005a34952b44e2c187e.jpg, createdBy=48fb4806846, createdName=Serendipity lai, createdTime=Sat Oct 23 20:25:51 CST 2021, time=2021-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1836277, encodeId=1bd318362e7f3, content=<a href='/topic/show?id=4613e1212fc' target=_blank style='color:#2F92EE;'>#痴呆症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71212, encryptionId=4613e1212fc, topicName=痴呆症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=726030, createdName=Boyinsh, createdTime=Wed Nov 03 17:10:15 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1048850, encodeId=fe34104885061, content=老年人痴呆何药可用??, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=junJUN, createdTime=Sun Aug 01 18:10:15 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1004407, encodeId=50e4100440e17, content=棒棒哒, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=86e45329161, createdName=148c6444m63暂无昵称, createdTime=Sun Aug 01 15:17:44 CST 2021, time=2021-08-01, status=1, ipAttribution=)]
    2021-08-01 148c6444m63暂无昵称

    棒棒哒

    0

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