Lisabeth Lynda, Harlow Sioban, Qaqish Bahjat
Department of Epidemiology, University of Michigan, 109 Observatory Street, Ann Arbor, MI 48109, USA.
J Clin Epidemiol. 2004 May;57(5):484-96. doi: 10.1016/j.jclinepi.2003.10.005.
To describe population mean, variance, and correlation of cycle length across the life span and by age at menopause and age at menarche using a new statistical approach.
Data from the Tremin Trust (n=997), a prospective menstrual diary study, was analyzed. Marginal models with generalized estimating equations were used to describe changes in menstrual parameters across the reproductive life span.
During the menopausal transition, the increase in standard deviation preceded that in mean by 2 to 6 years. Although beginning earlier in women with earlier menopause, increases in mean and variance for women with different ages at menopause were parallel. Women with later menopause had longer cycles throughout life and longer, more variable cycles during the transition.
The transition from late reproductive life to early menopausal transition appears to begin in the late thirties when variability of cycle length increases. Patterns of change in menstrual function during the menopausal transition do not differ by age at menopause; thus, differences in age at menopause are likely to reflect changes in the timing and not changes in the process of ovarian senescence, at least for the normative ages of menopause.
采用一种新的统计方法,描述整个生命周期以及按绝经年龄和初潮年龄划分的月经周期长度的总体均值、方差和相关性。
对来自前瞻性月经日记研究“特里明信托”(n = 997)的数据进行了分析。使用带有广义估计方程的边际模型来描述整个生殖生命周期中月经参数的变化。
在绝经过渡期间,标准差的增加比均值的增加提前2至6年。尽管绝经较早的女性这种增加开始得更早,但不同绝经年龄女性的均值和方差增加是平行的。绝经较晚的女性一生的月经周期更长,在过渡期间周期更长且更具变异性。
从生殖后期到绝经早期的过渡似乎始于三十多岁后期,此时月经周期长度的变异性增加。绝经过渡期间月经功能的变化模式不因绝经年龄而异;因此,绝经年龄的差异可能反映的是时间上的变化,而非卵巢衰老过程的变化,至少对于绝经的正常年龄来说是这样。