Soriguer Federico, Morcillo Sonsoles, Hernando Virginia, Valdés Sergio, Ruiz de Adana Maria Soledad, Olveira Gabriel, Fuentes Eduardo García, González Inmaculada, Tapia Maria José, Esteva Isabel, Rojo-Martínez Gemma
Endocrinology and Nutrition Service, Hospital Carlos Haya, Malaga, Spain.
Menopause. 2009 Jul-Aug;16(4):817-21. doi: 10.1097/gme.0b013e31819d4113.
The aim of this study was to undertake a prospective study of the changes in certain risk factors for cardiovascular disease occurring during menopause.
A longitudinal cohort study of 475 women was followed up for 6 years (Pizarra Study). The final menstrual period was defined after at least 6 months of amenorrhea. The women were classified into three groups: group 1, no menopause at either the first or second study; group 2, no menopause at the first study but menopause at the second study (6 y later); and group 3, menopause at the first study (and also at the second). The following are the main outcome measures used: age; body mass index; waist circumference; waist-to-hip ratio; skinfold thickness; arm circumference; intake of macronutrients (quantitative questionnaire); systolic and diastolic blood pressures; cholesterol, triglycerides; high-density lipoprotein cholesterol; uric acid; homeostasis model assessment of insulin resistance; and the prevalence of obesity, hypertension, type 2 diabetes mellitus, impaired glucose tolerance, and impaired fasting glucose.
None of the cardiovascular risk factors studied changed during the passage from premenopause to postmenopause, independently of age or physical activity.
Menopause is a biological condition of the human species, for which has recently received attempts at medicalization that were not always justified. If menopause is not accompanied by any other cardiovascular risk factor independently of age, the stigma of menopause being considered a risk factor should cease. Although the results have the strength of a prospective study, the sample size forced us to consider these findings as preliminary.
本研究旨在对绝经期间发生的某些心血管疾病风险因素的变化进行前瞻性研究。
对475名女性进行了一项为期6年的纵向队列研究(皮萨拉研究)。在至少6个月闭经后确定末次月经。这些女性被分为三组:第1组,在第一次或第二次研究时均未绝经;第2组,第一次研究时未绝经但第二次研究时绝经(6年后);第3组,第一次研究时绝经(第二次研究时也绝经)。以下是所使用的主要结局指标:年龄;体重指数;腰围;腰臀比;皮褶厚度;上臂围;常量营养素摄入量(定量问卷);收缩压和舒张压;胆固醇、甘油三酯;高密度脂蛋白胆固醇;尿酸;胰岛素抵抗的稳态模型评估;以及肥胖、高血压、2型糖尿病、糖耐量受损和空腹血糖受损的患病率。
所研究的心血管风险因素在从绝经前到绝经后的过程中均未发生变化,与年龄或体力活动无关。
绝经是人类的一种生理状态,最近人们试图将其医学化,但这种做法并不总是合理的。如果绝经不伴有任何独立于年龄的其他心血管风险因素,那么将绝经视为风险因素的污名就应该消除。尽管这些结果具有前瞻性研究的力度,但样本量迫使我们将这些发现视为初步结果。