Heart disease risk determines menopausal age rather than the reverse
Heart disease risk determines menopausal age rather than the reverse
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DOI：
10.1016/j.jacc.2005.12.066
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发表时间：
2006-05-16
影响因子：
24
通讯作者：
Grobbee, Diederick E.
中科院分区：
文献类型：
--
作者：
Kok, Helen S.;van Asselt, Kristel M.;Grobbee, Diederick E.
本研究的目的是调查是否有害的心血管疾病的危险因素加速绝经。背景绝经早期的妇女患心血管疾病的风险增加。虽然增加心血管疾病的风险已被提出作为绝经的后果，备择假设，即增加绝经前心血管疾病的风险，促进早期绝经，需要检查。这项研究始于1948年，从那时起每两年对参与者进行一次随访。入组研究时为绝经前且在至少两轮检查后达到自然绝经的女性纳入研究（n = 695）。测定绝经前血清总胆固醇、相对体重、血压和脆性风险评分的非年龄依赖性水平，以及绝经前胆固醇、体重和血压的变化。和绝经前的血压。绝经前血清总胆固醇的降低与绝经年龄的增加有统计学意义。血压降低与绝经年龄推迟有关，但这种关联在统计学上不显著。相对体重的下降与绝经年龄的显著提前有关。绝经前心脏病风险评分每高1%，绝经年龄降低1.8岁（95%置信区间-2.72至0.92）。结论研究结果支持心脏病风险决定绝经年龄的观点。这为心血管疾病发病率及其与绝经年龄和激素替代治疗效果的关系的不一致结果提供了新的解释。（J Am Con Cardiol 2006;47：1976 - 83）（c）美国心脏病学会基金会2006年。
OBJECTIVES The purpose of this study was to investigate whether a harmful cardiovascular risk profile accelerates menopause.BACKGROUND Women with an early menopause are at an increased risk of cardiovascular disease. Although increased cardiovascular risk has been proposed as consequence of menopause, the alternative hypothesis, that increased premenopausal cardiovascular risk promotes early menopause, needs to be examined.METHODS We used data from the Framingham Heart Study cohort. This study started in 1948 and has followed up participants biennially since then. Women who were premenopausal at study entry and who reached natural menopause after at least two examination rounds were included in the study (n = 695). Premenopausal age-independent levels of serum total cholesterol, relative weight, blood pressure, and Framingham risk score were determined, as well as premenopausal changes in cholesterol, body weight, and blood pressure.RESULTS A higher premenopausal serum total cholesterol level was statistically significantly associated with an earlier age at menopause, as were increases in total serum cholesterol, relative weight, and blood pressure in the premenopausal period. A decrease in total serum cholesterol during premenopause was statistically significantly associated with later age at menopause. Decreasing blood pressure was associated with a later menopausal age, but this association was not statistically significant. A decrease in relative weight was associated with a significant earlier age at menopause. Each 1% higher premenopausal Framingham risk score was associated with a decrease in menopausal age of 1.8 years (95% confidence interval -2.72 to -0.92).CONCLUSIONS The findings support the view that heart disease risk determines age at menopause. This offers a novel explanation for the inconsistent findings on cardiovascular disease rate and its relationship to menopausal age and effects of hormone replacement therapy. (J Am Con Cardiol 2006;47:1976 - 83) (c) 2006 by the American College of Cardiology Foundation.