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绝经后脊髓灰质炎幸存者的激素替代疗法与健康行为

Hormone replacement therapy and health behavior in postmenopausal polio survivors.

作者信息

Kalpakjian Claire Z, Riley Barth B, Quint Elisabeth H, Tate Denise G

机构信息

Department of Physical Medicine and Rehabilitation, University of Michigan, MPB D4100, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0718, USA.

出版信息

Maturitas. 2004 Aug 20;48(4):398-410. doi: 10.1016/j.maturitas.2003.10.007.

Abstract

OBJECTIVES

Little is known about menopause and hormone replacement therapy (HRT) use in women with disabilities. The objectives of this study were to explore the health behaviors, health outcomes, and efficacy of HRT in a group of postmenopausal polio survivors and to compare selected outcomes to nationally representative cohorts.

METHODS

One hundred and thirty-one postmenopausal polio survivors completed self-report surveys on health behaviors, HRT use, functional status, and psychosocial well-being. During a physical examination, fasting cholesterol and body mass index (BMI) were collected. Independent sample t-tests and Chi-square analysis were used to compare HRT users and non-users on health behaviors and health outcomes; logistic regression was used to predict HRT use.

RESULTS

Prevalence of HRT use was 58%. Only BMI predicted HRT use (OR = 0.30, CI: 0.11-0.81). HRT users had better high density lipoprotein (HDL), low density lipoprotein, total cholesterol/HDL ratios, lower BMIs, were more confident when communicating with their physicians, more likely to discuss menopause with their physician, and experienced greater overall stress. HRT was not associated with health behavior, health-related quality of life, mood, or life satisfaction. Compared to non-disabled women, more of these women had higher total cholesterol, obesity, more sleeping problems, and were less likely to vigorously exercise or smoke.

CONCLUSIONS

HRT did not confer substantial benefits in these postmenopausal polio survivors to warrant them using HRT at a higher rate than their non-disabled peers. Comparisons to their non-disabled peers suggested they may be at higher risk for adverse health problems associated with postmenopause.

摘要

目的

关于残疾女性的更年期及激素替代疗法(HRT)使用情况,人们了解甚少。本研究的目的是探讨一组绝经后脊髓灰质炎幸存者的健康行为、健康结局及HRT的疗效,并将选定的结局与具有全国代表性的队列进行比较。

方法

131名绝经后脊髓灰质炎幸存者完成了关于健康行为、HRT使用、功能状态和心理社会幸福感的自我报告调查。在体格检查期间,收集了空腹胆固醇和体重指数(BMI)。采用独立样本t检验和卡方分析来比较HRT使用者和非使用者在健康行为和健康结局方面的差异;使用逻辑回归来预测HRT的使用情况。

结果

HRT的使用率为58%。只有BMI可预测HRT的使用情况(OR = 0.30,CI:0.11 - 0.81)。HRT使用者的高密度脂蛋白(HDL)、低密度脂蛋白、总胆固醇/HDL比值更佳,BMI更低,与医生沟通时更自信,更有可能与医生讨论更年期问题,且总体压力更大。HRT与健康行为、健康相关生活质量、情绪或生活满意度无关。与非残疾女性相比,这些女性中更多人总胆固醇较高、肥胖、睡眠问题更多,且进行剧烈运动或吸烟的可能性更小。

结论

在这些绝经后脊髓灰质炎幸存者中,HRT并未带来实质性益处,使其使用HRT的比例高于非残疾同龄人。与非残疾同龄人相比,表明她们可能面临与绝经后相关的不良健康问题的更高风险。

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