日裔美国女性潮热症状真的比欧裔美国女性少吗?希洛女性健康研究。
Do Japanese American women really have fewer hot flashes than European Americans? The Hilo Women's Health Study.
作者信息
Brown Daniel E, Sievert Lynnette Leidy, Morrison Lynn A, Reza Angela M, Mills Phoebe S
机构信息
Department of Anthropology, University of Hawaii at Hilo, Hilo, HI 96720-4091, USA.
出版信息
Menopause. 2009 Sep-Oct;16(5):870-6. doi: 10.1097/gme.0b013e31819d88da.
OBJECTIVE
Many studies have found a significantly lower frequency of reported hot flashes (HFs) in Japanese and Japanese American (JA) populations, leading to speculation about possible dietary, genetic, or cultural differences. These studies have relied on subjective reports of HFs. Accordingly, the purpose of this study was to compare both reported and objective HFs measured by sternal and nuchal skin conductance among JA and European American (EA) women.
METHODS
Two surveys of HF frequencies were carried out among women of either EA or JA ethnicity; aged 45 to 55 years; living in Hilo, Hawaii; and not using exogenous hormones. The first was a postal questionnaire (n = 325); the second was carried out during a clinical study of HFs (n = 134). Women in the second group underwent 24-hour ambulatory and 3-hour laboratory monitoring for objective HFs measured through skin conductance at sternal and nuchal sites. Subjective HFs were recorded on the monitor or in a diary.
RESULTS
JAs were significantly less likely to report having had HFs in the previous 2 weeks compared with EAs (postal sample: JAs, 30.9%; EAs, 43.9%; chi(2) = 6.9, P < 0.01; monitored sample: JAs, 26.1%; EAs, 46.6%; chi(2) = 5.3, P < 0.05). JAs were also significantly less likely to report experiencing other symptoms (15 of 30 in the postal sample; 6 of 30 in the monitored sample) than EAs. However, JAs did not significantly differ in likelihood of reporting subjective HFs during the 24-hour ambulatory period (JAs, 51.1%; EAs, 55.8%; chi(2) = 0.3, NS), nor in percentage of individuals displaying one or more objective HFs as measured by the skin conductance monitor (JAs, 77.8%; EAs, 72.1%; chi(2) = 0.5, NS). JAs also did not have a significantly fewer number of objective HFs (t = 0.2, NS) nor of subjective HFs (t = 0.8, NS) during the monitoring period, and these results were unchanged when analyses controlled for menopause status and body mass index.
CONCLUSIONS
The common finding of fewer reported HFs in people of Japanese ancestry may be a consequence of reporting bias: JAs report fewer symptoms of many conditions compared with people from other ethnic groups. This is probably due to cultural conceptions of what is appropriate to report.
目的
许多研究发现,日本及日裔美国人中报告的潮热(HFs)频率显著较低,这引发了对可能存在的饮食、遗传或文化差异的猜测。这些研究依赖于潮热的主观报告。因此,本研究的目的是比较日裔美国(JA)女性和欧裔美国(EA)女性报告的潮热与通过胸骨和颈部皮肤电导测量的客观潮热情况。
方法
对年龄在45至55岁、居住在夏威夷希洛且未使用外源性激素的EA或JA族裔女性进行了两次潮热频率调查。第一次是邮寄问卷调查(n = 325);第二次是在潮热的临床研究期间进行的(n = 134)。第二组女性接受了24小时动态监测和3小时实验室监测,以通过胸骨和颈部部位的皮肤电导测量客观潮热情况。主观潮热情况记录在监测设备上或日记中。
结果
与EA女性相比,JA女性在过去2周内报告有潮热的可能性显著更低(邮寄样本:JA女性为30.9%,EA女性为43.9%;χ² = 6.9,P < 0.01;监测样本:JA女性为26.1%,EA女性为46.6%;χ² = 5.3,P < 0.05)。与EA女性相比,JA女性报告出现其他症状的可能性也显著更低(邮寄样本中30人中有15人;监测样本中30人中有6人)。然而,在24小时动态监测期间,JA女性报告主观潮热的可能性并无显著差异(JA女性为51.1%,EA女性为55.8%;χ² = 0.3,无统计学意义),通过皮肤电导监测仪测量显示有一次或多次客观潮热的个体百分比也无显著差异(JA女性为77.8%,EA女性为72.1%;χ² = 0.5,无统计学意义)。在监测期间,JA女性的客观潮热次数(t = 0.2,无统计学意义)和主观潮热次数(t = 0.8,无统计学意义)也没有显著更少,在对绝经状态和体重指数进行分析控制后,这些结果没有变化。
结论
在日裔人群中报告的潮热较少这一常见发现可能是报告偏倚的结果:与其他族裔的人相比,JA女性报告的多种病症症状较少。这可能是由于对于报告什么是合适的文化观念所致。