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60 岁及以上女性的生殖史与绝经后类风湿关节炎:第三次国家健康和营养检查调查。

Reproductive history and postmenopausal rheumatoid arthritis among women 60 years or older: Third National Health and Nutrition Examination Survey.

机构信息

Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA 23501-1980, USA.

出版信息

Menopause. 2013 Sep;20(9):930-5. doi: 10.1097/GME.0b013e3182a14372.

DOI:10.1097/GME.0b013e3182a14372
PMID:23942247
Abstract

OBJECTIVE

Rheumatoid arthritis, a condition of unknown etiology, has been associated with considerable costs to society. The purpose of this study is to determine whether selected reproductive history characteristics are associated with postmenopausal rheumatoid arthritis diagnosis.

METHODS

Secondary analyses were performed using cross-sectional data from the Third National Health and Nutrition Examination Survey. Of 1,892 eligible participants, 182 fulfilled the criteria for postmenopausal rheumatoid arthritis, based on self-report and the 1987 American College of Rheumatology criteria. Logistic regression models were constructed, and odds ratios (ORs) with their 95% CIs were calculated for selected reproductive history characteristics as predictors of postmenopausal rheumatoid arthritis, after adjustment for potential confounders.

RESULTS

Multivariate logistic models suggested that age at menopause was the only reproductive characteristic that was significantly associated with the outcome of interest (OR, 0.96; 95% CI, 0.93-0.99). Compared with women experiencing menopause at 50 years of age or later, those who experienced menopause before 40 years of age (OR, 2.53; 95% CI, 1.41-4.53) had increased odds of postmenopausal rheumatoid arthritis.

CONCLUSIONS

Women who experience menopause before 40 years of age seem to be at increased risk for postmenopausal rheumatoid arthritis. Conversely, age at menarche and pregnancy history may not predict rheumatoid arthritis after menopause. Further research is needed to confirm and elucidate these epidemiological findings.

摘要

目的

病因不明的类风湿关节炎给社会带来了相当大的负担。本研究旨在确定某些生殖史特征是否与绝经后类风湿关节炎的诊断有关。

方法

使用横断面数据进行二次分析,数据来自第三次国家健康和营养检查调查。在 1892 名合格参与者中,根据自我报告和 1987 年美国风湿病学会标准,有 182 人符合绝经后类风湿关节炎的标准。构建了逻辑回归模型,并计算了选定的生殖史特征作为绝经后类风湿关节炎预测因子的优势比(OR)及其 95%置信区间(CI),调整了潜在混杂因素。

结果

多变量逻辑模型表明,绝经年龄是唯一与研究结果显著相关的生殖特征(OR,0.96;95%CI,0.93-0.99)。与 50 岁或更晚绝经的女性相比,40 岁之前绝经的女性(OR,2.53;95%CI,1.41-4.53)绝经后患类风湿关节炎的几率增加。

结论

40 岁之前绝经的女性似乎患绝经后类风湿关节炎的风险增加。相反,初潮年龄和妊娠史可能不能预测绝经后的类风湿关节炎。需要进一步的研究来证实和阐明这些流行病学发现。

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