He L, Tang X, Hu Y H
Division of Non-Communicable Disease Control & Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Department of Epidemiologyand Biostatistics, Peking University School of Public Health, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2016 Jun 18;48(3):448-53.
To explore the associations of menopause with cardiovascular disease (CVD) and related metabolic disorders (including hypertension, diabetes or higher blood sugar, obesity, dyslipidemia) in Chinese females aged 45-59 years .
Data were acquired from a national cross-sectional survey conducted in 2013, China, which was also the second follow-up survey of China Health and Retirement Longitudinal Study (CHARLS). In the study, 4 702 Chinese perimenopausal women aged 45-59 years were enrolled, including 1 769 premenopausal women and 2 933 postmenopausal women. Information was collected from questionnaires of health status and functioning and physical examination. General liner models were employed to calculate age-adjusted or age-and-body-mass-index-adjusted or multiple-factor-adjusted means and their 95% confidence intervals (95% CIs) of cardiovascular risk factors (CRFs). The comparisons of CVD and its risk factors according to menopausal status, and calculation of adjusted odds ratios (ORs) and their 95%CIs for the associations of menopause with CVD and its risk factors were performed by multivariate Logistic regression models separately.
After adjustment for age and other confounders (including body mass index, marriage, education, current smoking, drink alcohol more than once per month), statistically significant associations of menopause with cardiovascular disease, which referred to having a history of heart disease or stroke in this study,were observed in the participants (OR=1.34,95%CI: 1.04-1.74); prevalence of hypertension (OR=1.42, 95%CI: 1.10-1.84), prevalence of CRFs clustering number≥2 (OR=1.31, 95%CI: 1.02-1.68) and average waist circumference level (87.11 cm, 95%CI: 86.81-87.42 cm in post-menopausal group vs. 86.41 cm, 95%CI: 85.99-86.84 cm in premenopausal group) were presented higher in postmenopausal group, compared with the premenopausal one. However, diabetes or higher blood sugar (OR= 0.96, 95%CI: 0.60-1.52), dyslipidemia (OR= 0.84, 95%CI: 0.59-1.20) and obesity (OR=1.06, 95%CI: 0.86-1.32) were not shown significantly statistically related to menopause, after excluding effect of age and other confounders.
Postmenopausal women in China had worse CRFs profile than the premenopausal ones, which implied menopause might aggravate the CRFs epidemic and increase the risk of cardiovascular disease beyond effects of aging, which would increase the CVD burden during and after their middle ages.
探讨45 - 59岁中国女性绝经与心血管疾病(CVD)及相关代谢紊乱(包括高血压、糖尿病或血糖升高、肥胖、血脂异常)之间的关联。
数据来自2013年在中国进行的一项全国性横断面调查,该调查也是中国健康与养老追踪调查(CHARLS)的第二次随访调查。本研究纳入了4702名45 - 59岁的中国围绝经期女性,其中包括1769名绝经前女性和2933名绝经后女性。通过健康状况和功能问卷以及体格检查收集信息。采用一般线性模型计算心血管危险因素(CRFs)的年龄调整或年龄和体重指数调整或多因素调整均值及其95%置信区间(95%CI)。根据绝经状态对CVD及其危险因素进行比较,并通过多变量Logistic回归模型分别计算绝经与CVD及其危险因素关联的调整比值比(OR)及其95%CI。
在调整年龄和其他混杂因素(包括体重指数、婚姻状况、教育程度、当前吸烟情况、每月饮酒超过一次)后,在参与者中观察到绝经与心血管疾病(本研究中定义为有心脏病或中风病史)之间存在统计学显著关联(OR = 1.34,95%CI:1.04 - 1.74);绝经后组高血压患病率(OR = 1.42,95%CI:1.10 - 1.84)、CRFs聚类数≥2的患病率(OR = 1.31,95%CI:1.02 - 1.68)以及平均腰围水平(绝经后组为87.11 cm,95%CI:86.81 - 87.42 cm;绝经前组为86.41 cm,95%CI:85.99 - 86.84 cm)均高于绝经前组。然而,在排除年龄和其他混杂因素的影响后,糖尿病或血糖升高(OR = 0.96,95%CI:0.60 - 1.52)、血脂异常(OR = 0.84,95%CI:0.59 - 1.20)和肥胖(OR = 1.06,95%CI:0.86 - 1.32)与绝经之间未显示出显著的统计学关联。
中国绝经后女性的CRFs状况比绝经前女性更差,这意味着绝经可能会加剧CRFs的流行,并增加心血管疾病风险,超出衰老的影响,这将增加她们中年及之后的CVD负担。