Woods Nancy Fugate, Cray Lori A, Mitchell Ellen Sullivan, Farrin Fred, Herting Jerald
1 School of Nursing, University of Washington, Seattle, WA, USA.
2 College of Nursing, Seattle University, Seattle, WA, USA.
Biol Res Nurs. 2018 Mar;20(2):153-160. doi: 10.1177/1099800417753536. Epub 2018 Jan 15.
During the menopausal transition and early postmenopause, participants in the Seattle Midlife Women's Health Study (SMWHS) experienced one of the three symptom severity clusters identified through latent class analysis: severe hot flashes with moderate sleep, mood, cognitive, and pain symptoms (high-severity hot flash); low-severity hot flashes with moderate levels of all other symptom groups (moderate severity); and low levels of all symptom groups (low severity). In an effort to determine whether gene polymorphisms were associated with these symptom severity classes, we tested associations between gene polymorphisms in the estrogen synthesis pathways (cytochrome P450 19 [CYP 19] and 17 beta hydroxysteroid dehydrogenase [ 17HSDB1]) and the three symptom severity clusters. SMWHS participants ( N = 137) recorded symptoms monthly in diaries and provided buccal smears for genotyping. Multilevel latent class analysis with multinomial regression was used to determine associations between gene polymorphisms and symptom severity clusters. Only the 17HSDB1 polymorphisms ( rs615942 and rs592389) were associated significantly with the high-severity hot flash cluster versus the low-severity symptom cluster. None of the polymorphisms was associated with the moderate-severity cluster versus the low-severity symptom cluster. Findings of associations of the 17HSDB1 polymorphisms with the high-severity hot flash symptom cluster are consistent with those of an association between 17HSDB1 polymorphisms and hot flashes in the Study of Women and Health Across the Nation population and our previous findings of associations between these polymorphisms with greater estrone levels.
在绝经过渡期间和绝经后早期，西雅图中年女性健康研究（SMWHS）的参与者经历了通过潜在类别分析确定的三种症状严重程度类别之一：伴有中度睡眠、情绪、认知和疼痛症状的严重潮热（高严重程度潮热）；所有其他症状组为中度水平的低严重程度潮热（中度严重程度）；以及所有症状组水平较低（低严重程度）。为了确定基因多态性是否与这些症状严重程度类别相关，我们测试了雌激素合成途径中的基因多态性（细胞色素P450 19 [CYP 19] 和17β-羟基类固醇脱氢酶 [17HSDB1]）与三种症状严重程度类别之间的关联。SMWHS参与者（N = 137）每月在日记中记录症状，并提供颊拭子进行基因分型。使用多水平潜在类别分析和多项回归来确定基因多态性与症状严重程度类别之间的关联。只有17HSDB1多态性（rs615942和rs592389）与高严重程度潮热类别相对于低严重程度症状类别显著相关。没有一种多态性与中度严重程度类别相对于低严重程度症状类别相关。17HSDB1多态性与高严重程度潮热症状类别之间的关联结果与全国妇女健康研究人群中17HSDB1多态性与潮热之间的关联以及我们之前关于这些多态性与更高雌酮水平之间关联的研究结果一致。
