Herber-Gast Gerrie-Cor M, Mishra Gita D
From the School of Population Health, University of Queensland, Brisbane, Australia.
Menopause. 2014 Aug;21(8):855-60. doi: 10.1097/GME.0000000000000171.
The purpose of this study was to investigate associations between profiles of vasomotor menopausal symptoms (VMS) during the menopausal transition with the prevalence of diabetes.
VMS and diabetes were measured at baseline and 3-year intervals for 15 years in 4,895 women in the Australian Longitudinal Study on Women's Health who were aged 45 to 50 years at baseline in 1996. Latent class analysis and generalized estimating equation models for binary repeated measures were performed. The VMS profiles were labeled as mild, moderate, early severe, and late severe.
The prevalence of diabetes in the total group was 9.0%. Compared with mild VMS, the odds of diabetes were higher in those with a late severe profile (though not statistically significant; adjusted odds ratio, 1.28; 95% CI, 0.97-1.68) and in those with an early severe profile (adjusted odds ratio, 1.67; 95% CI, 1.20-2.32). Adjustment for body mass index attenuated this association, but the odds of diabetes were still significantly higher in women with an early severe profile than in women with mild VMS (odds ratio, 1.55; 95% CI, 1.11-2.17). The moderate profile was not associated with diabetes.
Women with an early severe VMS profile are more likely to have diabetes across a period of 15 years. This association is not explained by body mass index or other potential confounders. Our findings imply that the predictive value of VMS for diabetes may vary with the timing of VMS relative to menopause.
本研究旨在调查绝经过渡期间血管舒缩性更年期症状(VMS)的特征与糖尿病患病率之间的关联。
在澳大利亚女性健康纵向研究中,对1996年基线年龄为45至50岁的4895名女性进行了为期15年的研究,在基线及之后每3年测量一次VMS和糖尿病情况。进行了潜在类别分析和二元重复测量的广义估计方程模型分析。VMS特征被标记为轻度、中度、早期重度和晚期重度。
总人群中糖尿病患病率为9.0%。与轻度VMS相比,晚期重度特征者患糖尿病的几率更高(尽管无统计学意义;调整后的优势比为1.28;95%置信区间为0.97 - 1.68),早期重度特征者患糖尿病的几率也更高(调整后的优势比为1.67;95%置信区间为1.20 - 2.32)。对体重指数进行调整后,这种关联有所减弱,但早期重度特征的女性患糖尿病的几率仍显著高于轻度VMS的女性(优势比为1.55;95%置信区间为1.11 - 2.17)。中度特征与糖尿病无关。
早期重度VMS特征的女性在15年期间患糖尿病的可能性更大。这种关联不能用体重指数或其他潜在混杂因素来解释。我们的研究结果表明,VMS对糖尿病的预测价值可能因VMS相对于绝经的时间而异。