Sanchez-Barajas Mauricio, Ibarra-Reynoso Lorena Del Rocio, Ayala-Garcia Marco Antonio, Malacara Juan Manuel
Department of Internal Medicine, Instituto Mexicano del Seguro Social, General Hospital Zone/MF 21, Leon, Guanajuato, Mexico.
Department of Medical Sciences, University of Guanajuato, León Campus, León, GTO, Mexico.
BMC Womens Health. 2018 Sep 20;18(1):153. doi: 10.1186/s12905-018-0648-3.
Women after menopause increase risk for cardiovascular disease and several factors may be related. The purpose was to study biological and psychosocial factors associated with early cardiovascular damage in pre- and postmenopausal women, assessed with carotid intima-media thickness vs flow-mediated dilatation.
Women 45 to 57 years old were grouped in the pre- (n = 60), early (n = 58) and late post-menopause (n = 59). Anthropometric, metabolic and hormonal data were registered, as well as measures of depression, anxiety, submission, perceived stress, and sleep alterations. Heart Rate Variability was recorded to obtain the information regarding sympathovagal balance. Carotid intima-media thickness and flow-mediated dilatation were assessed by ultrasound. Two-way ANOVA and multiple regression model were used.
At late postmenopause, the carotid intima-media was thicker (p < 0.001) and flow-mediated dilatation decreased (p < 0.001). Carotid intima-media thickness was associated positively with age (p < 0.001), submission score (p = 0.029), follicle stimulating hormone levels (p < 0.001), and body mass index (p = 0.009). Flow-mediated dilatation was associated only with age (p < 0.001). Regarding heart rate variability, the time domain pNN50 measurement was higher in premenopausal women (p = 0.001), Low Frequency (LF) was higher in the two groups of postmenopausal (p = 0.001) and High Frequency (HF) higher in the early postmenopausal women (p = 0.042).
Under our conditions carotid intima-media thickness had higher predictive value for early cardiovascular damage at menopause. The finding of the association of the submission score, indicates de influence of stress on vascular damage.
绝经后女性患心血管疾病疾病疾病绝经后心血管疾病风险增加，可能与多种因素有关。本研究旨在通过颈动脉内膜中层厚度与血流介导的血管舒张功能来评估绝经前后女性早期心血管损伤相关的生物学和心理社会因素。
将45至57岁女性分为绝经前组（n = 60）、绝经早期组（n = 58）和绝经后期组（n = 59）。记录人体测量、代谢和激素数据，以及抑郁、焦虑、顺从性、感知压力和睡眠改变的测量值。记录心率变异性以获取有关交感神经 - 迷走神经平衡的信息。通过超声评估颈动脉内膜中层厚度和血流介导的血管舒张功能。使用双向方差分析和多元回归模型。
在绝经后期，颈动脉内膜中层更厚（p < 0.001），血流介导的血管舒张功能下降（p < 0.001）。颈动脉内膜中层厚度与年龄（p < 0.001）、顺从性评分（p = 0.029）、促卵泡激素水平（p < 0.001）和体重指数（p = 0.009）呈正相关。血流介导的血管舒张功能仅与年龄相关（p < 0.001）。关于心率变异性，绝经前女性的时域pNN50测量值更高（p = 0.001），绝经后两组的低频（LF）更高（p = 0.001），绝经早期女性的高频（HF）更高（p = 0.042）。
在我们的研究条件下，颈动脉内膜中层厚度对绝经时早期心血管损伤具有更高的预测价值。顺从性评分相关性的发现表明压力对血管损伤的影响。
