Duration of menopausal hot flushes and associated risk factors.
Duration of menopausal hot flushes and associated risk factors.
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DOI：
10.1097/aog.0b013e318214f0de
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发表时间：
2011-05
影响因子：
7.2
通讯作者：
Gracia CR
中科院分区：
文献类型：
--
作者：
Freeman EW;Sammel MD;Lin H;Liu Z;Gracia CR
估计中度至重度绝经期潮热的持续时间，并确定潮热持续时间的潜在危险因素。Penn卵巢老化研究队列随访了13年。通过面对面访谈，每隔9个月至12个月对潮热进行评价。主要结局是中度至重度潮热的持续时间，通过生存分析估计（N=259）。潜在的危险因素包括绝经阶段、年龄、种族、生殖激素水平、体重指数（BMI）和当前吸烟。次要分析包括报告任何潮热的女性（N=349）。中度至重度潮热的中位持续时间为10.2年，与发病时的绝经阶段密切相关。在进入绝经过渡期时开始的潮热的中位持续时间> 11.57年;在早期过渡期发作的中位持续时间为7.35年（95%CI 4.94，8.89），P<0.001）;在晚期过渡到绝经后阶段发病的中位持续时间为3.84年（95%CI：1.77，5.52），P<0.001。中度至重度潮热发作时最常见的年龄为45-49岁（中位持续时间8.1年; 95% CI 5.12，9.28）。在校正分析中，非裔美国女性潮热持续时间长于白色女性。潮热的中位持续时间大大超过了临床实践中普遍接受的时间范围。确定的风险因素，特别是绝经阶段，种族和BMI，在个体化治疗和评估激素和其他治疗的风险受益比时需要考虑。
To estimate the duration of moderate-to-severe menopausal hot flushes and identify potential risk factors for hot flush duration. The Penn Ovarian Aging Study cohort was followed for 13 years. Hot flushes were evaluated at 9-month to 12-month intervals through in-person interviews. The primary outcome was the duration of moderate to severe hot flushes, estimated by survival analysis (N=259). Potential risk factors included menopausal stage, age, race, reproductive hormone levels, body mass index (BMI) and current smoking. A secondary analysis included women who reported any hot flushes (N=349). The median duration of moderate to severe hot flushes was 10.2 years and was strongly associated with menopausal stage at onset. Hot flushes that commenced near entry into the menopause transition had a median duration >greater than 11.57 years; onset in the early transition stage had a median duration of 7.35 years (95% CI 4.94, 8.89), P<0.001); and onset in the late transition to postmenopausal stages had a median duration of 3.84 years (95% CI: 1.77, 5.52), P<0.001. The most common ages at onset of moderate-to-severe hot flushes were 45–49 years (median duration 8.1 years; 95% CI 5.12, 9.28). African American women had a longer duration of hot flushes than white women in adjusted analysis. The median duration of hot flushes considerably exceeded the time frame that is generally accepted in clinical practice. The identified risk factors, particularly menopausal stage, race, and BMI, are important to consider in individualizing treatment and evaluating the risk to benefit ratio of hormones and other therapies.