摘要
背景绝经将引起一系列病理、生理变化和远期并发症(冠心病、脑血管疾病、骨质疏松等),其中冠心病是健康的头号杀手。目的探讨绝经状态改变以及年龄增长对中年女性冠心病常见高危因素颈动脉内膜中层厚度(CIMT)增厚、高血压、血脂异常、糖尿病、肥胖等的影响。方法选取2018年在首都医科大学附属北京世纪坛医院体检中心规律体检的45~54岁未绝经健康女性556名,根据相关标准剔除89名,最终纳入467名女性为研究对象。根据3年随访期间内是否绝经,将研究对象分为未绝经组(176名)和绝经组(291名),监测两组女性BMI、腰围、血糖、血压、血脂等指标的变化,并进行随访前后组间和组内比较。采用多因素Logistic回归分析探讨绝经状态与年龄对中年女性冠心病高危因素(CIMT增厚、高血压)发病率的影响。结果467名研究对象平均年龄为(47.6±2.3)岁;与基线相比,研究对象3年后腰围、尿酸(UA)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均升高,空腹血糖(FBG)水平降低(P<0.05)。组间比较:3年后,两组女性腰围、BMI、TG、FBG、高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05);绝经组女性UA、TC、LDL-C水平高于未绝经组(P<0.05)。组内比较:两组女性3年后腰围较基线水平均增加(P<0.05)。未绝经组女性在3年后的UA、TC、TG水平高于基线(P<0.05)。绝经组女性在3年后的UA、TC、TG、LDL-C水平均高于基线(P<0.05)。多因素Logistic回归分析结果显示,年龄≥50岁是中年女性CIMT增厚的高危因素(OR=2.475,95%CI=1.049~5.838,P=0.038)。结论中年女性腰围和TG的变化主要受到年龄增长的影响,LDL-C的变化主要受到绝经状态的影响,TC和UA的变化同时受到绝经状态和年龄增长的影响。中年女性年龄≥50岁是CIMT增厚的高危因素,绝经后UA、TC、LDL-C等代谢指标的变化先于CIMT的变化。
Background Menopause will cause series of pathophysiologic changes and long-term complications(coronary heart disease,cerebrovascular disease,osteoporosis,etc.),among which coronary heart disease is a major health threat.Objective To investigate the effects of menopausal status and aging on common risk factors for coronary heart disease(CHD)in middle-aged women,such as increased carotid intima-media thickness(CIMT),hypertension,dyslipidemia,diabetes,and obesity.Methods A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selected,with 89 excluded according to relevant criteria,and 467 women were finally included as study subjects.The included subjects were divided into the pre-menopausal group(n=176)and postmenopausal group(n=291)according to whether they were postmenopausal during a 3-year follow-up period.Changes in BMI,waist circumference,blood glucose,blood pressure,blood lipids and other indicators were monitored,inter-and intra-group comparisons were performed before and after the follow-up period.Multivariate Logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women.Results The average age of 467 subjects was(47.6±2.3)years old.Compared with baseline,waist circumference,uric acid(UA),total cholesterol(TC),triglyceride(TG),and low density lipoprotein cholesterol(LDL-C)levels increased,fasting blood glucose(FBG)level decreased after 3 years(P<0.05).The results of inter-group comparison showed that there was no significant difference in waist circumference,BMI,TG,FBG and high density lipoprotein cholesterol(HDL-C)levels between the two groups after three years(P<0.05);the levels of UA,TC and LDL-C in the menopausal group were higher than those in the pre-menopausal group,and the difference was statistically significant(
作者
杨慕坤
贾潇湘
任正洪
顾蓓
白文佩
YANG Mukun;JIA Xiaoxiang;REN Zhenghong;GU Bei;BAI Wenpei(Department of Obstetrics and Gynecology,Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China;Department of Obstetrics and Gynecology,Tongzhou Maternal and Child Health Hospital,Beijing 101101,China;School of Public Health,Peking University Health Science Center,Beijing 100191,China)
出处
《中国全科医学》
北大核心
2024年第3期280-285,共6页
Chinese General Practice
基金
北京市自然科学基金面上项目资助(7202075)
北京市医院管理中心“登峰”计划专项经费资助(DFL20190701)
北京市医院管理中心临床医学发展专项经费资助(ZYLX202112)。
关键词
冠心病
绝经
年龄
肥胖
中年女性
危险因素
前瞻性研究
队列研究
Coronary disease
Menopause
Age
Obesity
Middle-aged women
Risk factors
Prospective studies
Cohort studies
