Defining menopause status: creation of a new definition to identify the early changes of the menopausal transition
Defining menopause status: creation of a new definition to identify the early changes of the menopausal transition
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DOI：
10.1097/00042192-200512020-00005
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发表时间：
2005-01-01
影响因子：
2.7
通讯作者：
Nelson, DB
中科院分区：
文献类型：
--
作者：
Gracia, CR;Sammel, MD;Nelson, DB
目的：目前正在进行的旨在识别绝经期变化的研究中使用了几种绝经期分期定义。本研究的目的是确定哪个定义捕捉最早的激素变化在绝经transition.Design：在这项前瞻性队列研究中，年龄在35至47岁的妇女，随访5年。根据出血模式定义的2种不同绝经分期系统，将女性分为绝经前、早期过渡、晚期过渡和绝经后。比较了全国妇女健康研究（SWAN）和生殖衰老阶段研讨会（STAGES）的定义。还开发了一种新的绝经期分期系统（PENN-5），分为五组而不是四组，以区分周期长度变化更细微的妇女。对于每个分期系统，创建线性回归模型，比较每次评估时的平均激素值（FSH、LH、E-2、FSH、B B）和绝经期。种族，体重指数，周期日，吸烟，和随访时间包括在model.Results：统计学显着差异，平均卵泡刺激素B和FSH水平，但不是雌二醇水平，检测到最早的绝经阶段的每个定义之间。LH值的显着差异之间的最早阶段的SWAN和ESTA的定义，但不是PENN-5 definition.Conclusions：月经周期长度的微妙变化反映了显着的变化，在绝经过渡期的卵泡刺激素B和FSH水平。因此，似乎出血模式的细微变化可能有助于确定绝经过渡期最早的激素变化。
Objective: Several menopausal staging definitions are currently being used in ongoing studies designed to identify changes occurring during menopause. The objective of this study was to determine which definition captures the earliest hormonal changes in the menopausal transition.Design: In this prospective cohort study, women aged 35 to 47 years were, followed for 5 years. Women were classified as premenopausal, early transition, late transition, and postmenopausal by 2 different menopausal staging systems defined by bleeding patterns. Definitions from the Study of Women Health Across the Nation (SWAN) and Stages of Reproductive Aging Workshop (STRAW) were compared. A new menopausal staging system (PENN-5) was also developed with five groups rather than four to distinguish among women with more subtle changes in cycle length. For each staging system, a linear regression model was created comparing mean hormone values (inhibin B, FSH, LH, E-2) and menopausal stages at each assessment. Race, body mass index, cycle day, smoking, and follow-up time were included in the model.Results: Statistically significant differences in mean inhibin B and FSH levels, but not estradiol levels, were detected between the earliest menopausal stages of each definition. Significant differences in LH values were detected among the earliest stages of the SWAN and STRAW definitions, but not the PENN-5 definition.Conclusions: Subtle changes in menstrual cycle length reflect significant changes in inhibin B and FSH levels during the menopausal transition. Therefore, it appears that subtle changes in bleeding pattern may be helpful in identifying the earliest hormonal changes during menopausal transition.