Longitudinal study of hormone levels and depression among women transitioning through menopause
Longitudinal study of hormone levels and depression among women transitioning through menopause
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DOI：
10.1080/cmt.4.3.243.249
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发表时间：
2001-01
期刊：
影响因子：
2.8
通讯作者：
N. Avis;S. Crawford;R. Stellato;Christopher Longcope
中科院分区：
文献类型：
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作者：
N. Avis;S. Crawford;R. Stellato;Christopher Longcope
目的探讨绝经过渡期妇女抑郁与雌二醇绝对水平及其变化的关系。方法在美国马萨诸塞州进行了一项前瞻性、观察性研究。这里报告的分析是基于基线（T1-T3）后的前三次访谈。参与者是309名年龄在43-53岁之间的女性，她们总共提供了728个观察结果（每个受试者的平均观察次数为2.36）。主要结果测量是抑郁症，由流行病学抑郁症中心（CES-D）量表测量。结果CES-D评分与绝经状态类别无显著相关性，与雌二醇水平（E2）的年度变化也无显著相关性（p = 0.19）。log E2和CES-D之间的未校正相关性为负（比值比0.69），具有统计学显著性（p = 0.03）。然而，在调整症状后，相关性仍然为负，但不再具有统计学显著性（p = 0.26）。潮热/盗汗与CES-D呈正相关（p = 0.04），睡眠障碍与CES-D呈强正相关（p < 0.001）。结论：结果提供了强有力的支持多米诺骨牌或症状假说，假定抑郁情绪是由血管紧张症状与雌激素水平的变化。Eglomerate没有直接影响，独立于症状。这项研究增加了文献的主体，表明更年期和抑郁症之间的任何联系都很可能由其他因素解释，如症状和睡眠问题。研究结果还强调了研究绝经过渡期激素水平，睡眠问题和血管紧张症状之间复杂关系的重要性。
Objective To address the association between depression and absolute levels of estradiol, and change in estradiol, among women during the menopausal transition. Methods This was a prospective, observational study conducted in Massachusetts, USA. Analyses reported here are based on the first three interviews following baseline (T1–T3). The participants were 309 women aged initially 43–53 years, who contributed a total of 728 observations (mean number of observations per subject 2.36). The main outcome measure was depression as measured by the Center for Epidemiologic Studies-Depression (CES-D) scale. Results CES-D score was not significantly associated with menopause status categories, nor was it associated with annual change in estradiol level (E2) (p = 0.19). The unadjusted association between log E2 and CES-D was negative (odds ratio 0.69) and statistically significant (p = 0.03). Upon adjustment for symptoms, however, the association remained negative but was no longer statistically significant (p = 0.26). Hot flushes/night sweats were positively associated with CES-D (p = 0.04), and trouble sleeping was strongly positively related to CES-D (p < 0.001). Conclusions Results provide strong support for the domino or symptom hypothesis, which posits that depressed mood is caused by vasomotor symptoms associated with changing estrogen levels. Estradiol did not have a direct effect, independent of symptoms. This study adds to the body of literature suggesting that any association found between menopause and depression is most likely to be explained by other factors, such as symptoms and sleep problems. Findings also highlight the importance of studying the complex relationship between hormone levels, sleep problems and vasomotor symptoms during the menopausal transition.