de Kat A C, Dam V, Onland-Moret N C, Eijkemans M J C, Broekmans F J M, van der Schouw Y T
Department of Reproductive Medicine and Gynecology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht, 3508 GA, The Netherlands.
BMC Med. 2017 Jan 4;15(1):2. doi: 10.1186/s12916-016-0762-8.
Although the association between menopause and cardiovascular disease (CVD) risk has been studied extensively, the simultaneous role of chronological aging herein remains underexposed. This study aims to disentangle the relationships of menopausal status and chronological aging with CVD risk factors in the largest study population to date.
In this cross-sectional study, CVD risk factors were compared between women with a different menopausal status within the same yearly age strata. The study population comprised female participants of the baseline visit of the population-based LifeLines Cohort Study. A total of 63,466 women, aged between 18 and 65 years, was included. Of them, 39,379 women were considered to be premenopausal, 8669 were perimenopausal, 14,514 were naturally postmenopausal, and 904 were surgically postmenopausal.
Compared to postmenopausal women aged 45 years, average total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-c) were 0.5 and 0.4 mmol/L higher, respectively, in postmenopausal women aged 50. Systolic and diastolic blood pressure levels were 4 and 1 mmHg higher, respectively. At all ages between 46 and 55 years, and after adjustment for confounders, naturally postmenopausal women had 0.2 to 0.4 mmol/L higher TC and 0.1 to 0.3 mmol/L higher LDL-c levels compared to premenopausal women in the same age range. Systolic blood pressure levels were up to 4 mmHg lower in naturally post- compared to premenopausal women at all ages between 29 and 52 years. Body mass index levels were up to 3.2 kg/m higher in women with surgical menopause compared to all other women between the ages 32 and 52 years. All aforementioned results were statistically significant.
Chronological age and menopausal status are both independently associated with CVD risk factors. Based on the comparatively smaller observed differences associated with menopausal status than with chronological aging, the significance of a more unfavorable lipid profile in a later reproductive stage may be less obvious than previously thought.
尽管绝经与心血管疾病（CVD）风险之间的关联已得到广泛研究，但在此过程中实际年龄老化的同时作用仍未得到充分探讨。本研究旨在在迄今为止最大的研究人群中理清绝经状态和实际年龄老化与CVD风险因素之间的关系。
在这项横断面研究中，对同一年龄层内不同绝经状态的女性的CVD风险因素进行了比较。研究人群包括基于人群的生命线队列研究基线访视的女性参与者。总共纳入了63466名年龄在18至65岁之间的女性。其中，39379名女性被认为处于绝经前，8669名处于围绝经期，14514名自然绝经后，904名手术绝经后。
与45岁的绝经后女性相比，50岁的绝经后女性平均总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-c）分别高出0.5和0.4 mmol/L。收缩压和舒张压水平分别高出4和1 mmHg。在46至55岁的所有年龄段，在调整混杂因素后，自然绝经后女性的TC比同年龄范围内的绝经前女性高0.2至0.4 mmol/L，LDL-c水平高0.1至0.3 mmol/L。在29至52岁的所有年龄段，自然绝经后女性的收缩压水平比绝经前女性低4 mmHg。在32至52岁之间，手术绝经女性的体重指数水平比所有其他女性高3.2 kg/m²。所有上述结果均具有统计学意义。
实际年龄和绝经状态均与CVD风险因素独立相关。基于观察到的与绝经状态相关的差异相对小于与实际年龄老化相关的差异，在生殖后期更不利的血脂谱的重要性可能不如先前认为的那么明显。
