Menopause, Reproductive Life, Hormone Replacement Therapy, and Bone Phenotype at Age 60-64 Years: A British Birth Cohort.
Menopause, Reproductive Life, Hormone Replacement Therapy, and Bone Phenotype at Age 60-64 Years: A British Birth Cohort.
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DOI：
10.1210/jc.2016-1828
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Ward KA
中科院分区：
文献类型：
--
作者：
Kuh D;Muthuri S;Cooper R;Moore A;Mackinnon K;Cooper C;Adams JE;Hardy R;Ward KA
以前的研究绝经年龄和生殖寿命的长度对骨是有限的回顾性生殖史，是横截面，或缺乏金标准的骨技术或信息的激素替代疗法（HRT）或手术治疗。本研究的目的是调查绝经年龄、生殖寿命长度和HRT使用与60-64岁女性的体积和面积骨密度（vBMD、aBMD）、骨大小和强度的关系。这是一项出生队列研究，随访64年，前瞻性测量月经初潮和绝经年龄以及每月HRT史。这项研究在英格兰、苏格兰和威尔士进行。参与者包括848名已知绝经类型和60-64岁骨测量的妇女。测量桡骨远端总vBMD和骨小梁vBMD的外周定量计算机断层扫描测量值。骨干半径总和骨髓横截面积，皮质vBMD和极强度应变指数（SSI）;双能X线吸收测量法测量aBMD在腰椎和全髋关节也进行了测量。自然绝经（而非手术绝经）时年龄增加10岁与骨小梁vBMD增加8.2%（95%置信区间[CI] 1.3%-15.1%，P = 0.02）和总vBMD增加6.0%（95% CI 0.51%-11.5%，P = 0.03）相关;生殖寿命长短的结果相似。HRT使用的10年差异与6.0%（95% CI 2.6%-9.3%，P <0.001）的极SSI和0.9%（95% CI 0.4%-1.5%，P = 0.001）的皮质vBMD增加相关。这些估计在调整后变化不大。aBMD的估计值与外周定量计算机断层扫描的估计值一致。晚自然绝经和较长的生育寿命对骨小梁vBMD的积极影响持续到老年早期。HRT的使用与更大的桡骨皮质vBMD和极性SSI和aBMD相关。前瞻性评估，自然绝经期晚和生育期长与老年早期骨小梁vBMD相关; HRT与皮质vBMD、强度和脊柱aBMD相关。
Previous studies of menopausal age and length of reproductive life on bone are limited by retrospective reproductive histories, being cross-sectional, or lacking gold standard bone technologies or information on hormone replacement therapy (HRT) or surgical treatment. The objective of the study was to investigate age at menopause, length of reproductive life, and HRT use in relation to volumetric and areal bone mineral density (vBMD, aBMD), bone size, and strength in women aged 60–64 years. This was a birth cohort study that followed up for 64 years with prospective measures of age at menarche and menopause and monthly HRT histories. The study was conducted in England, Scotland, and Wales. Participants included 848 women with a known type of menopause and bone measures at 60–64 years. Peripheral quantitative computed tomography measurements of the distal radius total and trabecular vBMD were measured. Diaphyseal radius total and medullary cross-sectional area, cortical vBMD, and polar strength strain index (SSI); dual-energy x-ray absorptiometry measurements of aBMD at the lumbar spine and total hip were also measured. A 10-year increase in age at natural (but not surgical) menopause was associated with 8.2% (95% confidence interval [CI] 1.3%–15.1%, P = .02) greater trabecular vBMD and a 6.0% (95% CI 0.51%–11.5%, P = .03) greater total vBMD; findings were similar for length of reproductive life. A 10-year difference in HRT use was associated with a 6.0% (95% CI 2.6%–9.3%, P < .001) greater polar SSI and a 0.9% (95% CI 0.4%–1.5%, P = .001) greater cortical vBMD. These estimates changed little on adjustment. Estimates for aBMD were consistent with those for peripheral quantitative computed tomography. The positive effects on trabecular vBMD of later natural menopause and longer reproductive life persisted into early old age. HRT use was associated with greater radius cortical vBMD and polar SSI and aBMD. Later natural menopause and longer reproductive life, assessed prospectively, were associated with trabecular vBMD in early old age; HRT was associated with cortical vBMD, strength and spine aBMD.
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影响因子：
12.7
作者：
KRITZSILVERSTEIN, D;BARRETTCONNOR, E
通讯作者：
BARRETTCONNOR, E
DOI：
10.1111/j.1471-0528.2000.tb13333.x
发表时间：
2000-06-01
期刊：
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY
影响因子：
--
作者：
Kuh, D;Hardy, R;Wadsworth, M
通讯作者：
Wadsworth, M
影响因子：
4.9
作者：
Hardy, Rebecca;Mishra, Gita D.;Kuh, Diana
通讯作者：
Kuh, Diana
DOI：
10.1111/j.1471-0528.2007.01569.x
发表时间：
2008-01-01
影响因子：
5.8
作者：
Cooper, R.;Hardy, R.;Kuh, D.
通讯作者：
Kuh, D.
影响因子：
3.3
作者：
Gerdhem, P;Obrant, KJ
通讯作者：
Obrant, KJ