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[雌激素缺乏女性心血管疾病危险因素及骨密度状况的研究]

[Study on risk factors of cardiovascular disease and the status of bone mineral density in women with hypoestrogenism].

作者信息

Zhao Fang, Guo Xue-tao, Cheng Yun, Yang Zi-fen, Liu Hui-ping

机构信息

Department of Gynaecology and Obstetrics, First Hospital of Shanxi Medical University, Taiyuan 030001, China.

Department of Gynaecology and Obstetrics, First Hospital of Shanxi Medical University, Taiyuan 030001, China. Email: gxt_

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2013 Oct;48(10):734-9.

Abstract

OBJECTIVE

To study risk factors of cardiovascular disease (CVD) and status of bone mineral density (BMD) in women with hypoestrogenism.

METHODS

From Jul 2011 to April 2013, a total of 256 women with hypoestrogenism in the First Affiliated Hospital of Shanxi Medical University were enrolled in this retrospective study, which were divided into four groups:133 women in ppausal group, 25 women in premature ovarian failure (POF) group, 67 women in menopausal transition group and 31 women in premature ovarian failure transition group.General statue, CVD risk factors and BMD were compared among four groups.General statue include menopausal period, menopausal symptoms (Kupperman Index), CVD risk factors include body mass index, blood pressure, waist circumference, waist-hip ratio, blood lipids and glucose, BMD include left hip, lumbar spine bone mineral density and T or Z value.

RESULTS

(1) The median menopausal period were 3.4 years in postmenopausal group and 3.6 years in premature ovarian failure group, which did not show no statistical difference (P > 0.05).Kupperman Index in four groups were 12 in postmenopausal group, 9 in POF group, 9 in menopausal transition group and 8 in premature ovarian failure transition group, which reached statistical difference (P < 0.05).(2) The difference of body mass index (BMI), waist circumference, waist-hip ratio, diastolic blood pressure were no statistically significant among four groups(P > 0.05); the systolic blood pressure in four groups were 120, 110, 110, 110 mm Hg (1 mm Hg = 0.133 kPa), their differences were statistically significance (P < 0.05); the high-density lipoprotein (HDL-C) was 1.6 mmol/L in postmenopausal group, and 1.3 mmol/L in premature ovarian failure transition group, their differences were all statistically significance (P < 0.05); the difference of the fasting plasma glucose (FPG) was not statistically different in 4 groups (P > 0.05).(3) The abnormal rate of lower bone mass in lumbar spine were 57% (46/81) postmenopausal group, 8/15 in POF group, 32% (9/28) in menopausal transition group, 12/19 in premature ovarian failure transition group, and osteoporosis was 9% (7/81), 3/15, 1% (3/28) and 0 respectively , their differences were statistically different (P < 0.05); the abnormal rate of BMD of left hip and lumbar spine of 11/15 and 12/16 in POF group was higher than 65% (53/81) in postmenopausal group. In the mean time, the abnormal rate of BMD of left hip and lumbar spine were, 12/19 and 10/20 in premature ovarian failure transition group, which were significantly higher than 43% (12/28) and 39% (12/31) in the menopausal transition group.

CONCLUSIONS

The menopausal symptoms resulting from hypoestrogenism in natural postmenopausal women are mostly remarkable. The decrease of BMD in lumbar spine is more significant than that of left hip among postmenopausal women.Women with earlier menopause was prone to cause the changes of blood fat and abnormal of BMD, especially HDL-C decreased significantly compared with those natural postmenopause, it is more likely to cause CVD and osteoporosis.

摘要

目的

研究雌激素缺乏女性心血管疾病(CVD)的危险因素及骨密度(BMD)状况。

方法

选取2011年7月至2013年4月在山西医科大学第一附属医院就诊的256例雌激素缺乏女性进行回顾性研究,分为绝经组133例、卵巢早衰(POF)组25例、围绝经期组67例、卵巢早衰过渡组31例。比较四组的一般情况、CVD危险因素及BMD。一般情况包括绝经时间、绝经症状(Kupperman指数),CVD危险因素包括体重指数、血压、腰围、腰臀比、血脂和血糖,BMD包括左髋、腰椎骨密度及T或Z值。

结果

(1)绝经组中位绝经时间为3.4年,POF组为3.6年,差异无统计学意义(P>0.05)。四组Kupperman指数分别为绝经组12、POF组9、围绝经期组9、卵巢早衰过渡组8,差异有统计学意义(P<0.05)。(2)四组体重指数(BMI)、腰围、腰臀比、舒张压差异无统计学意义(P>0.05);四组收缩压分别为120、110、110、110 mmHg(1 mmHg = 0.133 kPa),差异有统计学意义(P<0.05);绝经组高密度脂蛋白(HDL-C)为1.6 mmol/L,卵巢早衰过渡组为1.3 mmol/L,差异有统计学意义(P<0.05);四组空腹血糖(FPG)差异无统计学意义(P>0.05)。(3)绝经组腰椎低骨量异常率为57%(46/81),POF组为8/15,围绝经期组为32%(9/28),卵巢早衰过渡组为12/19,骨质疏松率分别为9%(7/81)、3/15、1%(3/28)、0,差异有统计学意义(P<0.05);POF组左髋和腰椎BMD异常率11/15和12/16高于绝经组的65%(53/81)。同时,卵巢早衰过渡组左髋和腰椎BMD异常率分别为12/19和10/20,显著高于围绝经期组的43%(12/28)和39%(12/31)。

结论

自然绝经女性雌激素缺乏所致绝经症状大多较明显。绝经后女性腰椎BMD下降较左髋更显著。绝经较早的女性易引起血脂改变及BMD异常,尤其是HDL-C较自然绝经者显著降低,更易导致CVD及骨质疏松。

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