Department of Statistics, University of California Irvine, Irvine, California.
Division of Epidemiology, Department of Public Health Sciences, University of California Davis School of Medicine, Davis, California.
J Clin Endocrinol Metab. 2019 May 1;104(5):1404-1412. doi: 10.1210/jc.2018-00941.
Cardiometabolic conditions increase in midlife, but early customized prevention strategies are not established for such women.
To characterize and identify factors longitudinally related to constellations of cardiometabolic risk components in multiracial/ethnic women in midlife.
We conducted a prospective, longitudinal, multiethnic cohort study of 3003 midlife women undergoing menopausal transition (MT). Metabolic syndrome (MetS) was defined as having at least three of five components: high fasting triglyceride (hTG) level, low high-density lipoprotein cholesterol (lHDL-C) level, high fasting plasma glucose (hGluc) level, large waist circumference (abdominal obesity; Ob), and hypertension (HTN). We described the patterns of constellations and estimated hazard ratios (HRs) for constellations at (i) incident MetS and (ii) recovery from MetS, using multivariable-adjusted Cox regression.
Seven US sites.
In all, 1412 non-Hispanic white, 851 black, 272 Japanese, 237 Hispanic, and 231 Chinese women.
Race/ethnicity, lifestyle factors, and MT stage.
Cardiometabolic constellations, incident MetS, and MetS recovery.
Central obesity was the most frequent component. Having no components was the most frequent (31%) baseline constellation. Physical activity (HR = 1.68; 95% CI: 1.06, 2.68) and lower caloric intake (HR = 0.96; 95% CI: 0.93, 0.99 per 100 cal/d) were associated with recovery from MetS. Ob/hTG/lHDL-C (18%), Ob/HTN/lHDL-C (16%), and Ob/HTN/hGluc (14%) were frequent incident constellations. Physically active women had 26% to 62% lower hazards of incident MetS than inactive women.
Modifiable lifestyle behaviors were related to recovery from MetS and decreased risk of the most frequent MetS constellations in midlife women.
中年时期心血管代谢疾病的发病率增加，但针对此类女性的早期个性化预防策略尚未建立。
本研究旨在描述和确定与中年多种族/族裔女性心血管代谢风险成分星座相关的因素，并进行纵向分析。
我们开展了一项前瞻性、纵向、多民族队列研究，纳入了 3003 名处于更年期过渡（MT）阶段的中年女性。代谢综合征（MetS）的定义为至少存在五种成分中的三种：高空腹甘油三酯（hTG）水平、低高密度脂蛋白胆固醇（lHDL-C）水平、高空腹血糖（hGluc）水平、大腰围（腹部肥胖；Ob）和高血压（HTN）。我们描述了星座模式，并使用多变量调整的 Cox 回归估计了（i）新发 MetS 和（ii）MetS 恢复时星座的风险比（HRs）。
美国七个地点。
共有 1412 名非西班牙裔白人、851 名黑人、272 名日本人、237 名西班牙裔和 231 名中国人。
种族/民族、生活方式因素和 MT 阶段。
心血管代谢星座、新发 MetS 和 MetS 恢复。
中心性肥胖是最常见的成分。基线时最常见的星座模式是没有任何成分（占 31%）。体力活动（HR = 1.68；95%CI：1.06，2.68）和较低的热量摄入（HR = 0.96；95%CI：每 100 卡路里 0.93，0.99）与 MetS 的恢复相关。Ob/hTG/lHDL-C（18%）、Ob/HTN/lHDL-C（16%）和 Ob/HTN/hGluc（14%）是常见的新发星座。与不活跃的女性相比，活跃的女性新发 MetS 的风险降低了 26%至 62%。
可改变的生活方式行为与中年女性 MetS 的恢复以及最常见的 MetS 星座风险降低有关。
