Pansini F, Bacchi Modena A B, de Aloysio D, Gambacciani M, Meschia M, Parazzini F, Sciacchitano G, di Micco R, Peruzzi E, Maiocchi G
Departments of Obstetrics and Gynecology, Instituto Mario Negri, Milan, Italy.
Climacteric. 2000 Dec;3(4):241-7. doi: 10.1080/13697130008500142.
The aim of this analysis is to find any association between the use of hormone replacement therapy (HRT) and sociodemographic and clinical factors among women attending 54 menopause clinics in Italy.
The analysis includes data relating to 17,851 women who attended one of 54 menopause clinics in Italy for general gynecological evaluations and counselling between 1995 and 1997. The characteristics of women reporting ever HRT use were compared with those of never users. The odds ratios (ORs) of HRT use were computed in relation to selected reference categories, together with their 95% confidence intervals (CIs).
Of the 17,851 women interviewed, 8539 reported ever HRT use. The mean age of the never and ever HRT users was 52.8 years and 53.7 years, respectively. Higher education was associated with an increased frequency of HRT use: in comparison with women reporting no or primary-/middle-school education, the OR of HRT use of women reporting a high-school diploma or university degree was 1.3 (95% CI 1.1-1.6). HRT use tended to be less frequently reported with increasing body mass index (BMI): in comparison with women whose BMI was < 23.4 kg/m2, the OR of HRT use in those with a BMI of 23.4-26.1 kg/m2 and > or = 26.2 kg/m2 was 0.8 (95% CI 0.8-0.9) and 0.6 (95% CI 0.5-0.7), respectively. Among the postmenopausal women, those who had undergone surgical menopause had an OR of HRT use of 1.3 (95% CI 1.2-1.4). A history of breast cancer was associated with a lower frequency of HRT use (OR 0.3, 95% CI 0.2-0.4). Likewise, a history of thromboembolic disease (OR 0.5, 95% CI 0.4-0.7) or myocardial infarction (OR 0.7, 95% CI 0.6-0.9) was associated with a lower frequency of HRT use.
In our study population, the variable most closely related to HRT use was education/social class, thus underlining the impact of information campaigns on HRT and women's health. Among the medical determinants, our analysis indicates that a history of myocardial infarction, thromboembolic disease or breast cancer is associated with less frequent use of HRT.
本分析旨在找出在意大利54家更年期诊所就诊的女性中，激素替代疗法（HRT）的使用与社会人口统计学及临床因素之间的任何关联。
该分析纳入了1995年至1997年间在意大利54家更年期诊所之一就诊以进行一般妇科评估和咨询的17851名女性的数据。将报告曾使用过HRT的女性特征与从未使用者的特征进行比较。计算HRT使用的优势比（OR）及其选定参考类别的95%置信区间（CI）。
在接受访谈的17851名女性中，8539名报告曾使用过HRT。从未使用过HRT和曾使用过HRT的女性平均年龄分别为52.8岁和53.7岁。高等教育与HRT使用频率增加相关：与报告未接受教育或小学/中学教育的女性相比，报告拥有高中文凭或大学学位的女性使用HRT的OR为1.3（95%CI 1.1 - 1.6）。随着体重指数（BMI）增加，HRT使用报告频率往往降低：与BMI<23.4 kg/m²的女性相比，BMI为23.4 - 26.1 kg/m²和≥26.2 kg/m²的女性使用HRT的OR分别为0.8（95%CI 0.8 - 0.9）和0.6（95%CI 0.5 - 0.7）。在绝经后女性中，经历过手术绝经的女性使用HRT的OR为1.3（95%CI 1.2 - 1.4）。乳腺癌病史与HRT使用频率较低相关（OR 0.3，95%CI 0.2 - 0.4）。同样，血栓栓塞性疾病病史（OR 0.5，95%CI 0.4 - 0.7）或心肌梗死病史（OR 0.7，95%CI 0.6 - 0.9）与HRT使用频率较低相关。
在我们的研究人群中，与HRT使用最密切相关的变量是教育/社会阶层，从而突出了关于HRT和女性健康的宣传活动的影响。在医学决定因素中，我们的分析表明，心肌梗死、血栓栓塞性疾病或乳腺癌病史与HRT使用频率较低相关。
