Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; A 10/66 population-based cohort study.
Reproductive period, endogenous estrogen exposure and dementia incidence among women in Latin America and China; A 10/66 population-based cohort study.
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DOI：
10.1371/journal.pone.0192889
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发表时间：
2018
期刊：
影响因子：
3.7
通讯作者：
Valhuerdi A
中科院分区：
文献类型：
--
作者：
Prince MJ;Acosta D;Guerra M;Huang Y;Jimenez-Velazquez IZ;Llibre Rodriguez JJ;Salas A;Sosa AL;Chua KC;Dewey ME;Liu Z;Mayston R;Valhuerdi A
暴露于内源性雌激素可能会预防痴呆症，但证据仍然不明确。在外源性雌激素注射很少的情况下，这种影响可能会得到更准确的评估。我们的目的是确定生殖期(从月经初潮到更年期)和其他内源性雌激素暴露指标是否与痴呆症的发病率呈负相关。在古巴、多米尼加共和国、波多黎各和委内瑞拉的城市地点以及秘鲁、墨西哥和中国的农村和城市地点，对65岁及以上的妇女进行了基于人口的队列研究。对所有参与者进行了社会人口学和危险因素问卷调查，包括月经初潮年龄、第一个孩子的出生年龄、绝经年龄和产次，以确定三到五年后10/66痴呆症的发生率和死亡率。9428名女性参与了基线调查，其中72%-98%的人按地点做出了回应。高危人群包括8466名未患痴呆症的女性。平均年龄从72.0岁到75.4岁不等，农村低于城市，中国低于拉丁美洲。平均胎次为4.1(按地点计算为2.4-7.2)，农村地区普遍高于城市地区。对6854名有基线生育期数据的妇女进行了26463人年的跟踪调查。发生痴呆事件692例，无痴呆死亡895例。合并荟萃分析，每年生育期的固定效应(调整后的子危险比[ASHR]1.001，95%可信区间0.988-1.015)不支持与痴呆症发病率有任何关联，也没有证据表明载脂蛋白E基因对效应的影响。未观察到痴呆症的发生率与月经初潮年龄、第一个孩子的出生、绝经、未生育或累积内源性雌激素暴露指数之间的关系。产次较多与痴呆发生率呈正相关(ASHR 1.030，95%CI 1.002-1.059，I2=0.0%)。我们发现没有证据支持这样一种理论，即生育期内内源性雌激素累积暴露的自然变化会影响晚年痴呆的发病率。
Exposure to endogenous estrogen may protect against dementia, but evidence remains equivocal. Such effects may be assessed more precisely in settings where exogenous estrogen administration is rare. We aimed to determine whether reproductive period (menarche to menopause), and other indicators of endogenous estrogen exposure are inversely associated with dementia incidence. Population-based cohort studies of women aged 65 years and over in urban sites in Cuba, Dominican Republic, Puerto Rico and Venezuela, and rural and urban sites in Peru, Mexico and China. Sociodemographic and risk factor questionnaires were administered to all participants, including ages at menarche, birth of first child, and menopause, and parity, with ascertainment of incident 10/66 dementia, and mortality, three to five years later. 9,428 women participated at baseline, with 72–98% responding by site. The ‘at risk’ cohort comprised 8,466 dementia-free women. Mean age varied from 72.0 to 75.4 years, lower in rural than urban sites and in China than in Latin America. Mean parity was 4.1 (2.4–7.2 by site), generally higher in rural than urban sites. 6,854 women with baseline reproductive period data were followed up for 26,463 person years. There were 692 cases of incident dementia, and 895 dementia free deaths. Pooled meta-analysed fixed effects, per year, for reproductive period (Adjusted Sub-Hazard Ratio [ASHR] 1.001, 95% CI 0.988–1.015) did not support any association with dementia incidence, with no evidence for effect modification by APOE genotype. No association was observed between incident dementia and; ages at menarche, birth of first child, and menopause: nulliparity; or index of cumulative endogenous estrogen exposure. Greater parity was positively associated with incident dementia (ASHR 1.030, 95% CI 1.002–1.059, I2 = 0.0%). We found no evidence to support the theory that natural variation in cumulative exposure to endogenous oestrogens across the reproductive period influences dementia incidence in late life.
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影响因子：
2.1
作者：
Jotheeswaran AT;Williams JD;Prince MJ
通讯作者：
Prince MJ
拉丁美洲，印度和中国老年人的社会经济因素以及所有原因和特定原因的死亡率：一项基于人群的研究研究。
影响因子：
15.8
作者：
Ferri CP;Acosta D;Guerra M;Huang Y;Llibre-Rodriguez JJ;Salas A;Sosa AL;Williams JD;Gaona C;Liu Z;Noriega-Fernandez L;Jotheeswaran AT;Prince MJ
通讯作者：
Prince MJ
DOI：
10.1097/gme.0b013e3182960cf8
发表时间：
2013-06
期刊：
Menopause (New York, N.Y.)
影响因子：
--
作者：
Maki PM
通讯作者：
Maki PM
影响因子：
2.5
作者：
Hesson, Jacqueline
通讯作者：
Hesson, Jacqueline
影响因子：
3.5
作者：
Parsons, E;Newby, LK;Califf, RM
通讯作者：
Califf, RM