Institute for Postgraduate Medical Education, Prague, Czech Republic.
Physiol Res. 2012;61(6):587-96. doi: 10.33549/physiolres.932313. Epub 2012 Oct 25.
Cardiovascular disease, while rare in women of reproductive age, is the main cause of mortality in menopause. The purpose of our study was to determine the association of natural menopause with cardiovascular risk factors, including their clustering into metabolic syndrome (MS). A random 5 % representative population sample of women aged 45-54 years was examined. In 575 women, we were able to determine their natural reproductive aging status. Multiple regression analysis was used to calculate the association between age, menopausal status, and risk factors under study. After adjustment for age, there was an increase in the odds ratio of developing MS, as defined by NCEP (OR=2.0; 95 % CI [1.1; 3.7]), and an increase in plasma lipid ratios (total cholesterol/HDL-C, LDL-C/HDL-C, apolipoprotein-B/apolipoprotein-A1; p<0.05 for all) in postmenopausal women. Age, but not menopausal status, was associated with some single components of MS; only waist circumference significantly increased after menopause, independently of age. Clustering of risk factors in MS and lipid ratios (combined factors) was strongly associated with menopause whereas worsening of single components of MS was strongly associated with age. In conclusion, based on our results, the menopause may pose a risk to women through clustering of cardiovascular risk factors beyond simple aging.
心血管疾病在育龄期女性中较为少见，但却是绝经期女性死亡的主要原因。本研究旨在探讨自然绝经与心血管危险因素之间的关系，包括其与代谢综合征（MS）的聚集关系。我们对 45-54 岁的女性进行了随机 5%的代表性人群抽样调查。在 575 名女性中，我们确定了她们的自然生殖衰老状态。采用多元回归分析计算年龄、绝经状态与研究中危险因素之间的关系。在调整年龄后，NCEP 定义的 MS 发生的优势比（OR=2.0；95%CI [1.1;3.7]）增加，绝经后女性的血浆脂质比值（总胆固醇/高密度脂蛋白胆固醇、低密度脂蛋白胆固醇/高密度脂蛋白胆固醇、载脂蛋白 B/载脂蛋白 A1；所有 p<0.05）增加。年龄而不是绝经状态与 MS 的一些单一成分有关；只有腰围在绝经后独立于年龄显著增加。MS 中的危险因素聚集和脂质比值（综合因素）与绝经密切相关，而 MS 的单一成分恶化则与年龄密切相关。总之，基于我们的结果，绝经可能通过心血管危险因素的聚集对女性造成风险，而不仅仅是单纯的衰老。
