Reproductive history and postmenopausal rheumatoid arthritis among women 60 years or older: Third National Health and Nutrition Examination Survey
Reproductive history and postmenopausal rheumatoid arthritis among women 60 years or older: Third National Health and Nutrition Examination Survey
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DOI：
10.1097/gme.0b013e3182a14372
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发表时间：
2013-09-01
影响因子：
2.7
通讯作者：
Archer, David F.
中科院分区：
文献类型：
--
作者：
Beydoun, Hind A.;el-Amin, Rawan;Archer, David F.
目的：类风湿性关节炎是一种病因不明的疾病，已经给社会带来了相当大的代价。本研究的目的是确定选定的生育史特征是否与绝经后类风湿性关节炎的诊断有关。方法：使用第三次全国健康与营养检查调查的横断面数据进行二次分析。根据自我报告和1987年美国风湿病学会的标准，在1892名合格的参与者中，182人符合绝经后类风湿性关节炎的标准。建立Logistic回归模型，在调整潜在混杂因素后，计算选定的生育史特征作为绝经后类风湿性关节炎的预测因素的优势比(OR)及其95%的可信区间(OR)。结果：多因素Logistic模型显示，绝经年龄是唯一与关注结果显著相关的生殖特征(OR，0.96；95%CI，0.93-0.99)。与50岁或以上绝经妇女相比，40岁以前绝经妇女患绝经后类风湿关节炎的风险增加(OR=2.53；95%CI，1.41~4.53)。结论：40岁以前绝经妇女患绝经后类风湿关节炎的风险增加。相反，月经初潮年龄和孕产史可能不能预测绝经后的类风湿性关节炎。需要进一步的研究来证实和阐明这些流行病学发现。
Objective: Rheumatoid arthritis, a condition of unknown etiology, has been associated with considerable costs to society. The purpose of this study is to determine whether selected reproductive history characteristics are associated with postmenopausal rheumatoid arthritis diagnosis.Methods: Secondary analyses were performed using cross-sectional data from the Third National Health and Nutrition Examination Survey. Of 1,892 eligible participants, 182 fulfilled the criteria for postmenopausal rheumatoid arthritis, based on self-report and the 1987 American College of Rheumatology criteria. Logistic regression models were constructed, and odds ratios (ORs) with their 95% CIs were calculated for selected reproductive history characteristics as predictors of postmenopausal rheumatoid arthritis, after adjustment for potential confounders.Results: Multivariate logistic models suggested that age at menopause was the only reproductive characteristic that was significantly associated with the outcome of interest (OR, 0.96; 95% CI, 0.93-0.99). Compared with women experiencing menopause at 50 years of age or later, those who experienced menopause before 40 years of age (OR, 2.53; 95% CI, 1.41-4.53) had increased odds of postmenopausal rheumatoid arthritis.Conclusions: Women who experience menopause before 40 years of age seem to be at increased risk for postmenopausal rheumatoid arthritis. Conversely, age at menarche and pregnancy history may not predict rheumatoid arthritis after menopause. Further research is needed to confirm and elucidate these epidemiological findings.