Change in estradiol and follicle-stimulating hormone across the early menopausal transition: Effects of ethnicity and age
Change in estradiol and follicle-stimulating hormone across the early menopausal transition: Effects of ethnicity and age
复制标题
DOI：
10.1210/jc.2003-031183
复制
发表时间：
2004-04-01
影响因子：
5.8
通讯作者：
Little, RJ
中科院分区：
文献类型：
--
作者：
Randolph, JF;Sowers, M;Little, RJ
在一个以社区为基础的多种族中年妇女人群中纵向测量血清生殖激素浓度，以评估雌二醇（E2）和FSH的变化模式是否存在种族差异，如果存在，这些差异是否由宿主特征解释。我们研究了来自全国妇女健康研究（SWAN）7个临床中心的3257名参与者，基线时年龄为42-52岁，自认为是非裔美国人（28.2%），白人（47.1%），中国人（7.7%），西班牙人（8.4%）或日本人（8.6%）。在连续三次年度访视中，主要在自发月经周期的早期卵泡期采集血清，测定E2和FSH。重复测量回归分析的主要解释变量包括种族/民族、绝经状态、年龄、体重指数（BMI）、月经周期天数、吸烟、产次、社会经济状况、研究地点和基线时糖尿病自我报告。在基线访视时，46.2%的妇女被归类为围绝经期早期，其余为绝经前。第二次随访时，该队列中5.5%的妇女已绝经，66.8%的妇女处于绝经早期，8.3%的妇女处于绝经晚期，19.4%的妇女仍处于绝经前。FSH浓度随年龄增长而显著增加，年龄越大，增加越明显。在不同种族人群中发现了E2下降和FSH随年龄增加的相似模式，但这些激素的水平因种族/种族而异。具体而言，随着时间的推移，中国和日本女性的E2浓度较低，但与高加索女性相似的FSH水平，非洲裔美国女性的FSH浓度较高，但与高加索女性的E2水平相当。E2和FSH的这些种族差异与绝经状态无关。BMI对血清E2和FSH水平的影响因绝经状态而异。BMI增加与绝经前和围绝经期早期妇女E2浓度降低相关，但与围绝经期晚期和绝经后妇女E2浓度增加相关。BMI的增加与FSH浓度的降低有关，随着女性绝经过渡，BMI的影响变得更大。我们得出结论，中年女性血清E2水平随着年龄的增加而降低，FSH浓度随着年龄的增加而增加，E2随时间的种族差异与FSH的种族差异不同，并表明垂体-卵巢关系的种族差异，BMI对E2和FSH浓度的影响因绝经状态而异。
Serum reproductive hormone concentrations were measured longitudinally in a community-based, multiethnic population of midlife women to assess whether ethnic differences exist in the patterns of change in estradiol (E2) and FSH and, if so, whether these differences are explained by host characteristics. We studied 3257 participants from seven clinical sites in the Study of Women's Health Across the Nation (SWAN) who were aged 42-52 yr at baseline and self-identified as African American (28.2%), Caucasian (47.1%), Chinese (7.7%), Hispanic (8.4%), or Japanese (8.6%). E2 and FSH were assayed in serum collected primarily in the early follicular phase of a spontaneous menstrual cycle in three consecutive annual visits. The primary explanatory variables included in repeated-measures regression analyses were race/ethnicity, menopausal status, age, body mass index (BMI), day of the cycle, smoking, parity, socioeconomic status, study site, and the self-report of diabetes at baseline.At the baseline visit, 46.2% of the women were classified as being early perimenopausal, with the remaining being premenopausal. By the second follow-up visit, 5.5% of the women in that cohort were postmenopausal, 66.8% were early perimenopausal, 8.3% were late perimenopausal, and 19.4% remained premenopausal.Serum E2 concentrations decreased significantly with age, with a steeper decline at higher ages. FSH concentrations increased significantly with age, with a steeper increase at higher ages. Similar patterns in the decline of E2 and the increase in FSH with age were found across ethnic groups, but the levels of these hormones differed by race/ethnicity. Specifically, over time, Chinese and Japanese women had lower E2 concentrations but similar FSH levels, compared with Caucasian women, and African American women had higher FSH concentrations but comparable E2 levels with those of Caucasian women. These ethnic differences in E2 and FSH were independent of menopausal status. The effect of BMI on serum E2 and FSH levels varied by menopausal status. Increasing BMI was associated with decreasing concentrations of E2 among premenopausal and early perimenopausal women but was associated with increasing concentrations of E2 among late perimenopausal and postmenopausal women. Increasing BMI was associated with decreasing concentrations of FSH, with the effect of BMI becoming larger as women transitioned through menopause.We conclude that serum E2 levels decrease and FSH concentrations increase with increasing age in midlife women, that ethnic differences in E2 over time differ from ethnic differences in FSH and suggest ethnic differences in the pituitary-ovarian relationship, and that the effect of BMI on E2 and FSH concentrations varies by menopausal status.