Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition?
Are changes in cardiovascular disease risk factors in midlife women due to chronological aging or to the menopausal transition?
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DOI：
10.1016/j.jacc.2009.10.009
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发表时间：
2009-12-15
影响因子：
24
通讯作者：
Sutton-Tyrrell, Kim
中科院分区：
文献类型：
--
作者：
Matthews, Karen A.;Crawford, Sybil L.;Chae, Claudia U.;Everson-Rose, Susan A.;Sowers, Mary Fran;Sternfeld, Barbara;Sutton-Tyrrell, Kim
这项前瞻性研究在多种族队列中考察了在末次月经期(FMP)后一年内，传统的和新的冠心病(CHD)危险因素的变化是否比在该间隔之前或之后发生的变化更大。了解更年期对冠心病风险的影响仍然难以捉摸，主要是在高加索人样本中进行评估。全国妇女健康研究(SWAN)是对3302名少数民族(非裔美国人、西班牙裔、日本人或中国人)和高加索妇女的绝经过渡的前瞻性研究。经过10次年度检查，1054名女性获得了FMP，这不是因为手术，也是因为在FMP之前没有使用羟色胺。测量的冠心病危险因素包括血脂和脂蛋白、血糖、胰岛素、血压、纤维蛋白原和C反应蛋白。我们比较了两种模型中哪一种更符合观察到的与FMP相关的风险因素随时间的变化：线性模型，与时间顺序老化一致，或分段线性模型，与卵巢老化一致。只有总胆固醇、低密度脂蛋白-C和载脂蛋白-B在FMP前后1年的间隔时间内有显著升高，这与更年期诱导的变化一致。这一模式在不同种族之间是相似的。其他危险因素符合线性模型，表明年龄增长。女性在接受FMP治疗时会经历一种独特的血脂升高。围绝经期妇女血脂监测应加强对CHD的一级预防。
This prospective study examined if changes in traditional and novel coronary heart disease (CHD) risk factors are greater within a year of the final menstrual period (FMP), relative to changes that occur before or after that interval, in a multi-ethnic cohort. Understanding the influence of the menopause on CHD risk remains elusive and has been evaluated primarily in Caucasian samples. The Study of Women’s Health across the Nation (SWAN) is a prospective study of the menopausal transition in 3302 minority (African American, Hispanic, Japanese, or Chinese) and Caucasian women. After 10 annual exams, 1054 women had achieved a FMP not due to surgery and without HT use prior to FMP. Measured CHD risk factors included lipids and lipoproteins, glucose, insulin, blood pressure, fibrinogen, and C-reactive protein. We compared which of two models provided a better fit to the observed risk factor changes over time in relation to FMP: a linear model, consistent with chronological aging, or a piece-wise linear model, consistent with ovarian aging. Only total cholesterol, LDL-C, and apolipoprotein-B demonstrated substantial increases within the 1 year interval before and after FMP, consistent with menopause-induced changes. This pattern was similar across ethnic groups. The other risk factors were consistent with a linear model, indicative of chronological aging. Women experience a unique rise in lipids at the time of FMP. Monitoring lipids in perimenopausal women should enhance primary prevention of CHD.
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DOI：
10.3109/13697139909038063
发表时间：
1999-09-01
期刊：
Climacteric : the journal of the International Menopause Society
影响因子：
--
作者：
Guthrie, J R;Dennerstein, L;Dudley, E C
通讯作者：
Dudley, E C
影响因子：
7.7
作者：
BONITHONKOPP, C;SCARABIN, PY;GUIZE, L
通讯作者：
GUIZE, L
影响因子：
5.1
作者：
LINDQUIST, O
通讯作者：
LINDQUIST, O
影响因子：
6.8
作者：
AKAIKE, H
通讯作者：
AKAIKE, H
影响因子：
5
作者：
Do, KA;Green, A;Dennerstein, L
通讯作者：
Dennerstein, L