Association of Cumulative Lifetime Exposure to Female Hormones With Cerebral Small Vessel Disease in Postmenopausal Women in the UK Biobank.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
14 11 2023
14 11 2023
Historique:
received:
04
04
2023
accepted:
03
08
2023
pmc-release:
14
11
2024
medline:
15
11
2023
pubmed:
28
9
2023
entrez:
27
9
2023
Statut:
ppublish
Résumé
Rates of cerebrovascular disease increase after menopause, which is often attributed to the absence of hormones. It remains unknown whether the cumulative exposure to hormones across a female person's premenopausal life extends the window of cerebrovascular protection to the postmenopausal period. To investigate this, we examined the relationship between lifetime hormone exposure (LHE) and cerebral small vessel disease in more than 9,000 postmenopausal women in the UK-Biobank. The cohort consisted of women (aged 40-69 years) who attended one of 22 research centers across the United Kingdom between 2006 and 2010. Women were excluded if they were premenopausal when scanned, had missing reproductive history data, self-reported neurologic disorders, brain cancer, cerebral vascular incidents, head or neurologic injury, and nervous system infection. Endogenous LHE (LHE A total of 9,163 postmenopausal women (age 64.21 ± 6.81 years) were retained for analysis. Average LHE Women with more prolonged exposure to endogenous hormones show relatively smaller burden of cerebral small vessel disease independent of the history of oral contraceptive use or hormone replacement therapy. Our results highlight the critical role endogenous hormones play in female brain health and provide real-world evidence of the protective effects premenopausal endogenous hormone exposure plays on postmenopausal cerebrovascular health.
Sections du résumé
BACKGROUND AND OBJECTIVES
Rates of cerebrovascular disease increase after menopause, which is often attributed to the absence of hormones. It remains unknown whether the cumulative exposure to hormones across a female person's premenopausal life extends the window of cerebrovascular protection to the postmenopausal period. To investigate this, we examined the relationship between lifetime hormone exposure (LHE) and cerebral small vessel disease in more than 9,000 postmenopausal women in the UK-Biobank.
METHODS
The cohort consisted of women (aged 40-69 years) who attended one of 22 research centers across the United Kingdom between 2006 and 2010. Women were excluded if they were premenopausal when scanned, had missing reproductive history data, self-reported neurologic disorders, brain cancer, cerebral vascular incidents, head or neurologic injury, and nervous system infection. Endogenous LHE (LHE
RESULTS
A total of 9,163 postmenopausal women (age 64.21 ± 6.81 years) were retained for analysis. Average LHE
DISCUSSION
Women with more prolonged exposure to endogenous hormones show relatively smaller burden of cerebral small vessel disease independent of the history of oral contraceptive use or hormone replacement therapy. Our results highlight the critical role endogenous hormones play in female brain health and provide real-world evidence of the protective effects premenopausal endogenous hormone exposure plays on postmenopausal cerebrovascular health.
Identifiants
pubmed: 37758482
pii: WNL.0000000000207845
doi: 10.1212/WNL.0000000000207845
pmc: PMC10662980
doi:
Substances chimiques
Hormones
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e1970-e1978Informations de copyright
© 2023 American Academy of Neurology.
Références
Nat Neurosci. 2016 Nov;19(11):1523-1536
pubmed: 27643430
Neuroimage. 2018 Feb 1;166:400-424
pubmed: 29079522
Am J Physiol Heart Circ Physiol. 2015 Nov 15;309(10):H1679-96
pubmed: 26408543
Arterioscler Thromb Vasc Biol. 2009 Mar;29(3):289-95
pubmed: 19221203
Neurology. 2007 Jan 2;68(1):33-8
pubmed: 17200489
Recent Prog Horm Res. 2002;57:357-84
pubmed: 12017552
J Reprod Fertil. 2000 Nov;120(2):351-60
pubmed: 11058450
J Menopausal Med. 2020 Aug;26(2):69-98
pubmed: 32893509
J Stroke Cerebrovasc Dis. 2019 Mar;28(3):702-709
pubmed: 30482484
Hum Brain Mapp. 2021 Sep;42(13):4372-4386
pubmed: 34118094
Alzheimers Dement. 2023 Apr;19(4):1503-1517
pubmed: 36047604
Neuroepidemiology. 2022;56(3):183-191
pubmed: 35500554
J Appl Physiol (1985). 2006 Oct;101(4):1252-61
pubmed: 16794020
J Neurosci Res. 2017 Jan 2;95(1-2):24-39
pubmed: 27870427
J Steroid Biochem Mol Biol. 2016 Jun;160:53-66
pubmed: 26598278
JAMA Netw Open. 2020 Jan 3;3(1):e1919615
pubmed: 31968114
Endocr Rev. 2016 Aug;37(4):372-402
pubmed: 27196727
Lancet Neurol. 2013 Aug;12(8):822-38
pubmed: 23867200
Front Neurosci. 2015 Feb 20;9:37
pubmed: 25750611
Semin Reprod Med. 2012 Jan;30(1):46-61
pubmed: 22271294
Climacteric. 2005 Aug;8 Suppl 1:3-63
pubmed: 16112947
Hum Reprod Update. 2021 Oct 18;27(6):1115-1150
pubmed: 34432008
Menopause. 2020 Mar;27(3):305-310
pubmed: 31934946
Lancet Neurol. 2013 May;12(5):483-97
pubmed: 23602162
Neuropathol Appl Neurobiol. 2007 Dec;33(6):670-83
pubmed: 17990995
Post Reprod Health. 2020 Dec;26(4):181-209
pubmed: 33045914
Maturitas. 1997 Jun;27(2):117-23
pubmed: 9255746
N Engl J Med. 2020 Jan 30;382(5):446-455
pubmed: 31995690
Eur J Epidemiol. 2022 Mar;37(3):271-281
pubmed: 34989970
Am J Physiol Heart Circ Physiol. 2018 Dec 1;315(6):H1569-H1588
pubmed: 30216121
Am J Physiol Endocrinol Metab. 2003 Jan;284(1):E184-92
pubmed: 12388160
Eur Heart J. 2019 Jul 21;40(28):2290-2300
pubmed: 30854560
Lancet Neurol. 2010 Jul;9(7):689-701
pubmed: 20610345
BMJ. 2010 Jul 26;341:c3666
pubmed: 20660506
Neurology. 2022 Aug 30;99(9):e935-e943
pubmed: 35768207
Hum Brain Mapp. 2020 Nov;41(16):4718-4729
pubmed: 32767637
Hum Brain Mapp. 2021 Dec 1;42(17):5677-5688
pubmed: 34480503
J Am Heart Assoc. 2015 Jun 23;4(6):001140
pubmed: 26104658
Am J Epidemiol. 2020 Jul 1;189(7):660-670
pubmed: 31845729
Proc Natl Acad Sci U S A. 2019 Oct 29;116(44):22341-22346
pubmed: 31615888
Curr Opin Cardiol. 1994 Sep;9(5):619-26
pubmed: 7987043
EClinicalMedicine. 2021 Dec 14;43:101236
pubmed: 34977513
Pharmacol Rev. 2008 Jun;60(2):210-41
pubmed: 18579753
J Neuroendocrinol. 2009 Jun;21(6):550-7
pubmed: 19500225
Neurology. 2009 Jan 13;72(2):125-34
pubmed: 19139363
Trends Endocrinol Metab. 2003 Jul;14(5):228-35
pubmed: 12826329
Physiol Rev. 2017 Apr;97(2):495-528
pubmed: 28151424
J Alzheimers Dis. 2022;90(4):1535-1546
pubmed: 36278345