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2型糖尿病女性退伍军人的绝经后症状:血糖控制与症状严重程度

Postmenopausal Symptoms in Female Veterans with Type 2 Diabetes: Glucose Control and Symptom Severity.

作者信息

Rouen Patricia A, Krein Sarah L, Reame Nancy E

机构信息

1 McAuley School of Nursing, University of Detroit Mercy , Detroit, Michigan.

2 Center for Clinical Management Research , Veterans Affairs Healthcare System, Ann Arbor, Michigan.

出版信息

J Womens Health (Larchmt). 2015 Jun;24(6):496-505. doi: 10.1089/jwh.2014.4863. Epub 2015 May 4.

DOI:10.1089/jwh.2014.4863
PMID:25938989
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4490769/
Abstract

BACKGROUND

While type 2 diabetes mellitus (DM) is a common condition of midlife women, few studies have examined its influence on the symptom features of menopause. To explore this relationship, we conducted a study of symptom patterns of diabetic patients using a random sample of female veterans receiving care in the Veterans Affairs Healthcare system.

METHODS

A cross-sectional comparison was conducted with three groups of postmenopausal respondents (ages 45-60 years) to a mailed national survey who also consented to clinical data access: no diabetes (n=90), diabetes with better glucose control (hemoglobin A1c [HbA1c]≤7%, n=135) and diabetes with worse glucose control (HbA1c>7%, n=102).

RESULTS

Respondents, on average, were obese (body mass index: 33.9±0.4 kg/m(2)), 11.30±0.2 years postmenopause, with more than one chronic illness. Despite higher body mass index and increased comorbidities in women with diabetes compared with nondiabetic women, measures of mental health (anxiety, depressed mood, stress) were similar across groups. The pattern of menopause symptoms did not differ by group. Muscle aches/joint pain was the most prevalent symptom (78.6%), followed by vasomotor symptoms (74.4%). Respondents with elevated HbA1c demonstrated higher total menopausal symptom severity scores (DM-HbA1c>7: 15.4±0.8 vs. DM-HbA1c≤7%: 12.2±0.8 vs. No diabetes: 12.3±0.8; p=0.006) than the other two groups.

CONCLUSIONS

In postmenopausal female veterans with diabetes, glucose control is associated with the severity of those symptoms commonly attributed to menopause. Joint pain is an important part of the postmenopausal symptom complex in this population.

摘要

背景

虽然2型糖尿病(DM)是中年女性的常见病症,但很少有研究探讨其对更年期症状特征的影响。为了探究这种关系,我们对在退伍军人事务医疗系统接受治疗的女性退伍军人随机样本进行了糖尿病患者症状模式的研究。

方法

对三组绝经后受访者(年龄45 - 60岁)进行横断面比较,这些受访者回复了一份全国邮寄调查问卷,且同意获取其临床数据:无糖尿病组(n = 90)、血糖控制较好的糖尿病组(糖化血红蛋白[HbA1c]≤7%,n = 135)和血糖控制较差的糖尿病组(HbA1c>7%,n = 102)。

结果

受访者平均肥胖(体重指数:33.9±0.4 kg/m²),绝经后11.30±0.2年,患有一种以上慢性病。尽管与非糖尿病女性相比,糖尿病女性的体重指数更高且合并症更多,但各组的心理健康指标(焦虑、抑郁情绪、压力)相似。更年期症状模式在各组之间没有差异。肌肉疼痛/关节疼痛是最普遍的症状(78.6%),其次是血管舒缩症状(74.4%)。HbA1c升高的受访者更年期症状总严重程度得分高于其他两组(糖尿病-HbA1c>7%:15.4±0.8 vs. 糖尿病-HbA1c≤7%:12.2±0.8 vs. 无糖尿病:12.3±0.8;p = 0.006)。

结论

在患有糖尿病的绝经后女性退伍军人中,血糖控制与通常归因于更年期的症状严重程度相关。关节疼痛是该人群绝经后症状复合体的重要组成部分。