激素治疗对绝经后妇女姿势平衡的影响。

Effect of hormone therapy on postural balance in postmenopausal women.

机构信息

Department of Gynecology and Obstetrics, Botucatu Medical School, Sao Paulo State University-UNESP, Sao Paulo, Brazil.

出版信息

Menopause. 2012 Jul;19(7):768-75. doi: 10.1097/gme.0b013e318240fc36.

DOI:10.1097/gme.0b013e318240fc36

PMID:22473249

Abstract

OBJECTIVE

The aim of this study was to analyze the effects of hormone therapy (HT) on postural balance in postmenopausal women and its association with risk of falls.

METHODS

In this cross-sectional study, a total of 225 Brazilian postmenopausal women aged 45 to 75 years were included and divided into two groups: HT users (n = 102) and nonusers (n = 123). HT users were women who had continuously taken HT throughout the preceding 6 months, whereas nonusers received no such therapy during the same period. Women with amenorrhea for more than 12 months and aged 45 years or older were included. Those with neurological or musculoskeletal disorders, vestibulopathies, uncorrected visual deficit, or drug use that could affect balance were excluded. Histories of falls (previous 24 mo) as well as clinical and anthropometric characteristics were analyzed. Postural balance was assessed through stabilometry (computerized force platform), Romberg test, and crouching test. Statistical analysis included the median test, χ test, Spearman correlation coefficient, and logistic regression method (odds ratio).

RESULTS

Women users of HT were younger (53.0 vs 57.0 y) and with a shorter time since menopause (5.5 vs 10.0 y) than nonusers (P < 0.05). No anthropometric differences were observed. The number of women who had experienced falls was significantly lower among HT users than nonusers: 51 vs 88 falls, respectively (P < 0.05), and presented an adjusted risk of falls of 0.49 (95% CI, 0.27-0.88) times lower than the nonusers group. For the stabilometric parameters, HT users showed significantly lower amplitude in body oscillation (latero-lateral and antero-posterior) and a smaller oscillation area compared with nonusers (P < 0.05). There was no significant correlation between the Romberg test and fall rate (P > 0.05). In the crouching test, 47.1% of the participants showed an adequate level of muscle strength in lower limbs without differences between the groups (P > 0.05).

CONCLUSIONS

Postmenopausal women using HT showed lower frequency of falls and a better performance in stabilometric parameters than did nonusers.

摘要

目的

本研究旨在分析激素治疗（HT）对绝经后妇女姿势平衡的影响及其与跌倒风险的关系。

方法

本横断面研究共纳入 225 名年龄在 45 至 75 岁的巴西绝经后妇女，分为 HT 使用者组（n=102）和非使用者组（n=123）。HT 使用者组为过去 6 个月内持续服用 HT 的妇女，而非使用者组在同期内未接受任何此类治疗。纳入有停经 12 个月以上且年龄在 45 岁及以上的妇女。排除有神经或肌肉骨骼疾病、前庭疾病、未经矫正的视力缺陷或可能影响平衡的药物使用史的妇女。分析了跌倒史（过去 24 个月）以及临床和人体测量特征。通过稳定计（计算机力平台）、Romberg 测试和蹲伏测试评估姿势平衡。统计分析包括中位数检验、χ 检验、Spearman 相关系数和逻辑回归方法（比值比）。

结果

HT 使用者组的年龄（53.0 岁 vs. 57.0 岁）和绝经后时间（5.5 岁 vs. 10.0 岁）均较非使用者组年轻（P<0.05）。两组间人体测量学差异无统计学意义。HT 使用者组经历跌倒的女性人数明显少于非使用者组：分别为 51 次和 88 次跌倒（P<0.05），且跌倒风险调整后为非使用者组的 0.49 倍（95%CI，0.27-0.88）。在稳定计参数方面，HT 使用者组的身体摆动幅度（左右和前后）明显低于非使用者组，摆动面积也明显小于非使用者组（P<0.05）。Romberg 测试与跌倒率之间无显著相关性（P>0.05）。在蹲伏测试中，47.1%的参与者下肢肌肉力量足够，但两组间无差异（P>0.05）。