Zaydun Gulnisa, Tomiyama Hirofumi, Hashimoto Hideki, Arai Tomio, Koji Yutaka, Yambe Minoru, Motobe Kohki, Hori Saburou, Yamashina Akira
Second Department of Internal Medicine, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Tokyo 160-0023, Japan.
Atherosclerosis. 2006 Jan;184(1):137-42. doi: 10.1016/j.atherosclerosis.2005.03.043.
The present study examined whether the menopause augments the age-related increase in brachial-ankle pulse-wave velocity (PWV). In total, 3149 women (ranging in age from 21 to 94 years) undergoing an annual health screening examination were enrolled in a cross-sectional study. Conventional atherosclerotic risk factors were examined, and the brachial-ankle PWV of each subject was determined. The relationship between age and the brachial-ankle PWV assumed the form of a quadratic curve, and the slope of the curve was relatively steeper after the menopause (brachial-ankle PWV = 0.17 x age2 - 0.58 x age + 812) than before (brachial-ankle PWV = 0.23 x age2 - 8.92 x age + 1058). A logistic regression analysis conducted for subjects between the ages of 45 and 56 years (mean age of menopause +/- 2 standard deviations) demonstrated that women who had experienced the menopause at least 6 years previously demonstrated a significant risk of belonging to the highest PWV tertile {adjusted odds ratio: 2.08 (95% confidential interval: 1.04-4.17)}, independent of age and other atherosclerotic risk factors (hypertension, hypercholesterolemia, diabetes mellitus, obesity, and smoking). Thus, this study suggested that the menopause augments the age-related increase in arterial stiffness during the early postmenopausal phase and that this augmentation is probably related, at least in part, to estrogen deficiency. The contribution of this menopause-related increase in arterial stiffness to the risk of cardiovascular disease in postmenopausal women should be further evaluated.
本研究探讨了绝经是否会加剧与年龄相关的臂踝脉搏波速度(PWV)升高。共有3149名年龄在21至94岁之间接受年度健康筛查的女性纳入了一项横断面研究。研究了传统的动脉粥样硬化危险因素,并测定了每位受试者的臂踝PWV。年龄与臂踝PWV之间的关系呈二次曲线形式,绝经后曲线斜率相对更陡(臂踝PWV = 0.17×年龄² - 0.58×年龄 + 812),而绝经前为(臂踝PWV = 0.23×年龄² - 8.92×年龄 + 1058)。对年龄在45至56岁之间(绝经平均年龄±2个标准差)的受试者进行的逻辑回归分析表明,至少在6年前经历过绝经的女性属于PWV最高三分位数的风险显著增加{调整后的优势比:2.08(95%置信区间:1.04 - 4.17)},且独立于年龄和其他动脉粥样硬化危险因素(高血压、高胆固醇血症、糖尿病、肥胖和吸烟)。因此,本研究表明绝经会在绝经后早期加剧与年龄相关的动脉僵硬度增加,且这种加剧可能至少部分与雌激素缺乏有关。绝经相关的动脉僵硬度增加对绝经后女性心血管疾病风险的影响应进一步评估。