Factors Related to Age at Natural Menopause: Longitudinal Analyses From SWAN
Factors Related to Age at Natural Menopause: Longitudinal Analyses From SWAN
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DOI：
10.1093/aje/kws421
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发表时间：
2013-07-01
影响因子：
5
通讯作者：
Harlow, Sioban D.
中科院分区：
文献类型：
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作者：
Gold, Ellen B.;Crawford, Sybil L.;Harlow, Sioban D.
自然月经期(FMP)或绝经期的早年与许多健康结局有关，可能是未来健康状况不佳的标志。然而，影响绝经年龄的潜在可改变因素还没有在大量不同的人群中进行纵向检查。全国妇女健康研究(SWAN)跟踪了来自美国7个地点和5个种族/民族的3302名初步绝经前和早期围绝经期妇女，使用年度数据(1996-2007年)和COX比例风险模型来评估时不变和时变的社会人口、生活方式和健康因素与自然FMP年龄的关系。FMP的中位年龄为52.54岁(1,483例观察到的天然FMP)。控制社会人口、生活方式和健康因素，我们发现种族/民族在FMP中没有年龄差异。更高的教育水平、以前使用口服避孕药、基线体重较高、受雇、不吸烟、饮酒、较少从事体育活动以及在随访期间有更好的自我评估健康状况，与FMP中的较晚年龄显著相关。这些结果表明，自然FMP的年龄反映了健康和社会经济因素的复杂相互关系，这可以部分解释FMP的高龄与降低发病率和死亡率的关系。
Early age at the natural final menstrual period (FMP) or menopause has been associated with numerous health outcomes and might be a marker of future ill health. However, potentially modifiable factors affecting age at menopause have not been examined longitudinally in large, diverse populations. The Study of Women's Health Across the Nation (SWAN) followed 3,302 initially premenopausal and early perimenopausal women from 7 US sites and 5 racial/ethnic groups, using annual data (1996-2007) and Cox proportional hazards models to assess the relation of time-invariant and time-varying sociodemographic, lifestyle, and health factors to age at natural FMP. Median age at the FMP was 52.54 years (n = 1,483 observed natural FMPs). Controlling for sociodemographic, lifestyle, and health factors, we found that racial/ethnic groups did not differ in age at the FMP. Higher educational level, prior oral contraceptive use, and higher weight at baseline, as well as being employed, not smoking, consuming alcohol, having less physical activity, and having better self-rated health over follow-up, were significantly associated with later age at the FMP. These results suggest that age at the natural FMP reflects a complex interrelation of health and socioeconomic factors, which could partially explain the relation of late age at FMP to reduced morbidity and mortality.