Department of Clinical Science, University of Bergen, Bergen, Norway.
Core Facility for Metabolomics, University of Bergen, Bergen, Norway.
PLoS One. 2020 Jun 30;15(6):e0235478. doi: 10.1371/journal.pone.0235478. eCollection 2020.
Most women live to experience menopause and will spend 4-8 years transitioning from fertile age to full menstrual stop. Biologically, reproductive ageing is a continuous process, but by convention, it is defined categorically as pre-, peri- and postmenopause; categories that are sometimes supported by measurements of sex hormones in blood samples. We aimed to develop and validate a new tool, a reproductive ageing score (RAS), that could give a simple and yet precise description of the status of reproductive ageing, without hormone measurements, to be used by health professionals and researchers.
Questionnaire data on age, menstrual regularity and menstrual frequency was provided by the large multicentre population-based RHINE cohort. A continuous reproductive ageing score was developed from these variables, using techniques of fuzzy mathematics, to generate a decimal number ranging from 0.00 (nonmenopausal) to 1.00 (postmenopausal). The RAS was then validated with sex hormone measurements (follicle stimulating hormone and 17β-estradiol) and interview-data provided by the large population-based ECRHS cohort, using receiver-operating characteristics (ROC).
The RAS, developed from questionnaire data of the RHINE cohort, defined with high precision and accuracy the menopausal status as confirmed by interview and hormone data in the ECRHS cohort. The area under the ROC curve was 0.91 (95% Confidence interval (CI): 0.90-0.93) to distinguish nonmenopausal women from peri- and postmenopausal women, and 0.85 (95% CI: 0.83-0.88) to distinguish postmenopausal women from nonmenopausal and perimenopausal women.
The RAS provides a useful and valid tool for describing the status of reproductive ageing accurately, on a continuous scale from 0.00 to 1.00, based on simple questions and without requiring blood sampling. The score allows for a more precise differentiation than the conventional categorisation in pre-, peri- and postmenopause. This is useful for epidemiological research and clinical trials.
大多数女性都希望经历更年期，并在从生育期过渡到完全停经的 4-8 年内度过这段时期。从生物学上讲，生殖衰老属于一个连续的过程，但根据惯例，它被明确地定义为绝经前、围绝经期和绝经后；这些类别有时可以通过血液样本中的性激素测量来支持。我们旨在开发和验证一种新的工具，即生殖衰老评分（RAS），它可以在不进行激素测量的情况下，简单而精确地描述生殖衰老的状态，供健康专业人员和研究人员使用。
基于人群的大型 RHINE 队列提供了年龄、月经规律和月经频率的问卷调查数据。使用模糊数学技术，从这些变量中开发出一个连续的生殖衰老评分，生成一个从 0.00（非绝经）到 1.00（绝经后）的十进制数字。然后，使用基于人群的 ECRHS 队列提供的性激素测量（卵泡刺激素和 17β-雌二醇）和访谈数据，使用接收者操作特性（ROC）对 RAS 进行验证。
从 RHINE 队列的问卷调查数据中开发的 RAS，以高精确度和准确性定义了通过 ECRHS 队列的访谈和激素数据确认的绝经状态。ROC 曲线下的面积为 0.91（95%置信区间（CI）：0.90-0.93），用于区分非绝经女性和围绝经期女性，0.85（95%CI：0.83-0.88），用于区分绝经后女性和非绝经和围绝经期女性。
RAS 提供了一种有用且有效的工具，可基于简单的问题并无需采血，在 0.00 到 1.00 的连续范围内准确描述生殖衰老的状态。该评分比传统的绝经前、围绝经期和绝经后分类更能精确区分。这对于流行病学研究和临床试验非常有用。
