摘要
目的探讨女性高血压患者的月经初潮年龄、绝经年龄及生殖期与认知功能的关系。方法2018年7至8月在江西省婺源县开展高血压筛查,通过面对面问卷调查、体格测量及生化检测收集信息,利用简易精神状态检查量表(MMSE)评判认知功能。采用多重线性回归法和Logistic回归分析法分析月经初潮年龄、绝经年龄及生殖期对认知功能的影响,并采用惩罚样条法进行曲线关系拟合。结果自然绝经女性高血压患者4595例,平均年龄(65.1±8.4)岁,平均月经初潮年龄、绝经年龄及生殖期分别为(16.6±2.2)、(48.2±5.0)岁和(31.7±5.5)年,平均MMSE得分(19.0±6.3)分。认知功能障碍总检出率40.4%(1859/4595)。月经初潮年龄<15岁、15~16岁及≥17岁组患者的认知功能障碍检出率分别为28.4%、39.1%和45.8%,绝经年龄<45岁、45~49岁及≥50岁组患者的认知功能障碍检出率分别为47.9%、39.7%和38.3%,生殖期<25年、25~29年、30~34年及≥35年组患者的认知功能障碍检出率分别为56.0%、44.4%、40.6%和32.6%,不同年龄组间认知功能障碍检出率差异均有统计学意义(P均<0.05)。与月经初潮年龄<15岁组比较,月经初潮年龄15~16岁、≥17岁组检出认知功能障碍的比例较高(OR=1.45,95%CI=1.19~1.75,P<0.001;OR=1.65,95%CI=1.37~1.98,P<0.001);与绝经年龄<45岁组比较,绝经年龄45~49岁、≥50岁组检出认知功能障碍的比例较低(OR=0.80,95%CI=0.66~0.95,P=0.013;OR=0.78,95%CI=0.65~0.93,P<0.001);与生殖期<25年组比较,生殖期25~29年、30~34年及≥35年组检出认知功能障碍的比例较低(OR=0.66,95%CI=0.52~0.84,P<0.001;OR=0.62,95%CI=0.50~0.76,P<0.001;OR=0.51,95%CI=0.41~0.63,P<0.001)。结论月经初潮年龄与认知功能障碍的检出呈正相关,而绝经年龄、生殖期与认知功能障碍的检出呈负相关。
Objective To explore the relationship of menarche age,menopause age,and reproductive period with cognitive function in the female patients with hypertension.Methods Hypertension screening was carried out in Wuyuan county of Jiangxi province from July to August in 2018.Data were collected through a face-to-face questionnaire survey,physical measurement,and biochemical tests.The cognitive function was scored according to the mini-mental state examination(MMSE)scale.Multiple linear regression and Logistic regression were employed to analyze the effects of menarche age,menopause age,and reproductive period on cognitive function,and the penalized spline regression to fit the curves.Results A total of 4595 postmenopausal women with hypertension were included in the analysis,with the mean age of(65.1±8.4)years,mean menarche age of(16.6±2.2)years,mean menopause age of(48.2±5.0)years,mean reproductive period of(31.7±5.5)years,mean MMSE score of(19.0±6.3)points,and total cognitive impairment detection rate of 40.4%(1859/4595).The detection rates of cognitive impairment were 28.4%,39.1%,and 45.8%in the females with the menarche ages of<15,15-16,and≥17 years,47.9%,39.7%,and 38.3%in the females with the menopausal ages of<45,45-49,and≥50 years,and 56.0%,44.4%,40.6%,and 32.6%in the females with the reproductive periods of<25,25-29,30-34,and≥35 years,respectively.Moreover,the detection rates of cognitive impairment among different age groups were statistically significant(all P<0.05).Compared with the group with the menarche age<15 years,the groups with the menarche ages of 15-16 years and≥17 years showed increased detection rates of cognitive impairment(OR=1.45,95%CI=1.19-1.75,P<0.001;OR=1.65,95%CI=1.37-1.98,P<0.001).Compared with the group with the menopausal age<45 years,the groups with the menopausal ages of 45-49 years and≥50 years showed decreased detection rates of cognitive impairment(OR=0.80,95%CI=0.66-0.95,P=0.013;OR=0.78,95%CI=0.65-0.93,P<0.001).Compared with the group with the reproductive period<25 y
作者
游春娇
徐艳杰
余超
祝玲娟
王涛
周伟
鲍慧慧
程晓曙
YOU Chunjiao;XU Yanjie;YU Chao;ZHU Lingjuan;WANG Tao;ZHOU Wei;BAO Huihui;CHENG Xiaoshu(Department of Cardiovascular Medicine,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China;Center for Prevention and Treatment of Cardiovascular Diseases,The Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)
出处
《中国医学科学院学报》
CAS
CSCD
北大核心
2023年第5期760-767,共8页
Acta Academiae Medicinae Sinicae
基金
国家科技支撑计划(2011BAI11B01)
江西省卫生健康委科技计划项目(202210495)
江西省青年科学基金(2018BAB215003)。
关键词
月经初潮
绝经
生殖期
年龄
认知功能
menarche
menopause
reproductive period
age
cognitive function
