Finding a way through the forest: A Biopsychosocial model of hot flashes.
Finding a way through the forest: A Biopsychosocial model of hot flashes.
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寻找穿过森林的出路：潮热的生物心理社会模型。
DOI：
10.1097/gme.0b013e3181846cc6
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Matthews,KarenA
中科院分区：
文献类型：
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作者：
Thurston,RebeccaC;EversonRose,SusanA;Matthews,KarenA
Maas博士注意到（尽管不一致3，4）在以前的研究中潮热和血压升高之间的联系，并质疑血压的差异是否可以解释我们观察到的腹部肥胖和潮热之间的联系。在这些SWAN Heart参与者中，在考虑年龄后，收缩压（SBP）和舒张压（DBP）与潮热无显著相关性（p> 0.25）。此外，在多变量模型中控制SBP和DBP与其他协变量并没有减少观察到的腹部肥胖和潮热之间的关联（总肥胖：OR= 1.26，95% CI：1.02-1.57，p= 0.04;皮下肥胖：OR= 1.28，95%CI 1.03-1.60），p= 0.03）。Reame博士观察到，在SWAN心脏中，非裔美国人和白色女性之间内脏脂肪组织（VAT）与皮下脂肪组织（SAT）的相对分布不同，在非裔美国女性中SAT与VAT的比例更高。她指出，VAT是代谢更活跃的脂肪类型，与糖尿病等风险的相关性比SAT更强（尽管并非所有SAT都是代谢良性的5）。她指出，鉴于非裔美国妇女患糖尿病等疾病的风险增加，我们对脂肪分布中这些种族/民族差异的悖论保持沉默。这显然是一个重要问题。鉴于我们的出版物的重点是潮热，解决脂肪分布和代谢风险的种族/民族差异超出了我们的报告范围。然而，非洲裔美国妇女比白色妇女更容易报告潮热。6非裔美国女性的SAT也比白色女性多，这与潮热密切相关。我们没有报道，但确实研究了脂肪分布的种族差异是否可以解释潮热的种族差异。我们发现非洲人和非洲人之间潮热的差异
Dr. Maas notes the (albeit inconsistent3, 4) links between hot flashes and elevated blood pressure in previous research, and questions whether differences in blood pressure may account for our observed associations between abdominal adiposity and hot flashes. In these SWAN Heart participants, after accounting for age, neither systolic blood pressure (SBP) nor diastolic blood pressure (DBP) was significantly associated with hot flashes (p’s> 0.25). Moreover, controlling for SBP and DBP in multivariable models with other covariates did not reduce observed associations between abdominal adiposity and hot flashes (total adiposity: OR= 1.26, 95% CI: 1.02–1.57, p= 0.04; subcutaneous adiposity: OR= 1.28, 95% CI 1.03–1.60), p= 0.03).Dr. Reame observes that the relative distribution of visceral adipose tissue (VAT) versus subcutaneous adipose tissue (SAT) varied between the African American and White women in SWAN Heart, with proportionately more SAT versus VAT among the African American women. She notes that VAT is the more metabolically active type of fat, more strongly associated with risks such as diabetes than SAT (although not all SAT is so metabolically benign5). She indicates that we are silent on the paradox of these racial/ethnic differences in fat distribution, given that African American women are at increased risk for diseases such as diabetes. This is clearly an important issue. Given the focus of our publication on hot flashes, addressing racial/ethnic differences in fat distribution and metabolic risk was beyond the scope of our report. However, African American women are more likely to report hot flashes than White women. 6 African American women also have proportionately more SAT than White women, that most strongly related to hot flashes. 2 We did not report but did examine whether racial differences in hot flashes were accounted by these racial differences in fat distribution. We found that the differences in hot flashes between African