Hot flashes in the late reproductive years: Risk factors for African American and Caucasian women
Hot flashes in the late reproductive years: Risk factors for African American and Caucasian women
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DOI：
10.1089/152460901750067133
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发表时间：
2001-01-01
期刊：
影响因子：
--
通讯作者：
Hollander, L
中科院分区：
文献类型：
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作者：
Freeman, EW;Sammel, MD;Hollander, L
潮热是中年妇女寻求医疗护理的主要原因，但关于绝经前几年潮热的发病或预测因素的信息很少。这项研究检查了女性在生育后期的潮热经历，比较了非洲裔美国人和白人女性，并确定了与卵巢衰老相关的潮热的激素，行为和环境风险因素。数据来自一项基于人群的前瞻性卵巢老化队列研究，研究对象为35-47岁的女性，总体健康状况良好，研究入组时月经周期规律。在第一个随访期的结构化访谈中通过受试者报告评估潮热，并与既往潮热的前瞻性每日评级高度相关（p = 0.0001）。在入组时连续两个月经周期和随访时连续两个月经周期的月经周期前6天采集血样。预测变量包括激素指标、结构化访谈和标准问卷数据。31%的样本（n = 375）报告潮热（平均年龄41岁）。在双变量分析中，报告潮热的非裔美国女性多于白人女性（38% vs. 25%，p = 0.01）。在最终的多变量逻辑回归模型中，潮热的显著预测因子是较高的促卵泡激素（FSH）水平（比值比[OR] 3.19）、焦虑（OR 1.06）、基线绝经期症状（OR 4.91）、饮酒（OR 1.09）、体重指数（BMI）（OR 1.04）和产次（OR 1.20）。在调整这些变量后，种族并不能预测潮热。潮热通常发生在围绝经期可观察到的月经不规律之前，与激素和行为因素有关。潮热与体重增加（BMI）的关联挑战了目前的“瘦”假说，并提出了关于BMI在生殖后期激素动力学中的作用的重要问题。
Hot flashes are a primary reason that midlife women seek medical care, but there is little information about the onset or the predictors of hot flashes in the years before the menopause. This study examines women's experience of hot flashes in the late reproductive years, comparing African American and Caucasian women, and identifies hormonal, behavioral, and environmental risk factors for hot flashes associated with ovarian aging. Data are from a population-based prospective cohort study of ovarian aging in women who were ages 35-47, in general good health, and had regular menstrual cycles at study enrollment. Hot flashes were assessed by subject report in a structured interview at the first follow-up period and correlated highly with previous prospective daily ratings of hot flashes (p = 0.0001). Blood samples were obtained in the first 6 days of the menstrual cycle in two consecutive cycles at enrollment and two consecutive cycles at follow-up. Predictor variables include hormone measures, structured interview, and standard questionnaire data. Thirty-one percent of the sample (n = 375) reported hot flashes (mean age 41 years). In bivariate analysis, more African American than Caucasian women reported hot flashes (38% vs. 25%, p = 0.01). Significant predictors of hot flashes in the final multivariable logistic regression model were higher follicle-stimulating hormone (FSH) levels (odds ratio [OR] 3.19), anxiety (OR 1.06), baseline menopausal symptoms (OR 4.91), alcohol use (OR 1.09), body mass index (BMI) (OR 1.04), and parity (OR 1.20). Race did not predict hot flashes after adjusting for these variables. Hot flashes commonly occur before observable menstrual irregularities in the perimenopause and are associated with both hormonal and behavioral factors. The association of hot flashes with increased body mass (BMI) challenges the current "thin" hypothesis and raises important questions about the role of BMI in hormone dynamics in the late reproductive years.