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45-49 岁女性儿童肥胖与绝经症状的关联:澳大利亚队列研究。

The associations of childhood adiposity with menopausal symptoms in women aged 45-49 years: An Australian Cohort Study.

机构信息

Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.

Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; The George Institute for Global Health, University of Oxford, Oxford, UK.

出版信息

Maturitas. 2021 Jan;143:81-88. doi: 10.1016/j.maturitas.2020.09.008. Epub 2020 Oct 1.

Abstract

OBJECTIVES

To examine the associations of childhood adiposity with menopausal symptoms in women aged 45-49 years.

STUDY DESIGN

National population-based cohort study of 334 girls prospectively followed from childhood (aged 11-15) through to midlife (aged 45-49). Childhood overweight and obesity were defined by international age- and sex-specific standards for body mass index (BMI), and abdominal obesity was defined as waist/height ratio≥0.5.

MAIN OUTCOME MEASURES

Vasomotor symptoms (VMS), vaginal dryness, total menopausal symptoms and domain-specific symptoms (somatic, psychological and urogenital) were measured during 2018-19 using the Menopause Rating Scale (MRS) and classified as none, mild, moderate or severe.

RESULTS

The prevalence of mild, moderate and severe VMS was 24.0 %, 9.0 % and 3.9 %, and of vaginal dryness was 12.6 %, 4.8 % and 2.4 %. No significant associations of childhood overweight/obesity or abdominal obesity with VMS or vaginal dryness were found after adjustment for childhood age, follow-up length, smoking, socioeconomic status and diet quality. Childhood overweight/obesity was associated with increased risks of more severe total (RR:1.17, 95 % CI:1.02-1.36), psychological (RR:1.19, 95 % CI:1.04-1.35) and urogenital (RR:1.29, 95 % CI:1.14-1.46) symptoms measured using the MRS. Associations with childhood abdominal obesity were mostly stronger with more severe total (RR:2.19, 95 % CI:1.48-3.23), somatic (RR:1.52, 95 % CI:1.15-2.02), psychological (RR:1.21, 95 % CI:1.04-1.42) and urogenital (RR:2.11, 95 % CI:1.39-3.20) symptoms.

CONCLUSIONS

Childhood adiposity was not associated with increased risks of more severe VMS or vaginal dryness in women aged 45-49 years. Childhood adiposity, especially abdominal obesity, was associated with more severe total, somatic, psychological and urogenital symptoms. However, the association between these symptoms and menopause is not established.

摘要

目的

研究 45-49 岁女性儿童期肥胖与绝经症状的关系。

研究设计

这是一项全国性的队列研究,共纳入 334 名女孩,从儿童期(11-15 岁)开始进行前瞻性随访,直至中年(45-49 岁)。采用国际年龄和性别特定的 BMI 标准来定义儿童期超重和肥胖,腰围/身高比≥0.5 定义为腹型肥胖。

主要观察指标

使用绝经评定量表(MRS)在 2018-19 年期间测量血管舒缩症状(VMS)、阴道干燥、总绝经症状和特定领域症状(躯体、心理和泌尿生殖),并分为无、轻度、中度或重度。

结果

轻度、中度和重度 VMS 的患病率分别为 24.0%、9.0%和 3.9%,阴道干燥的患病率分别为 12.6%、4.8%和 2.4%。调整儿童期年龄、随访时间、吸烟、社会经济地位和饮食质量后,儿童期超重/肥胖或腹型肥胖与 VMS 或阴道干燥之间无显著相关性。儿童期超重/肥胖与 MRS 测量的更严重的总症状(RR:1.17,95%CI:1.02-1.36)、心理症状(RR:1.19,95%CI:1.04-1.35)和泌尿生殖症状(RR:1.29,95%CI:1.14-1.46)风险增加相关。与儿童期腹型肥胖相关的关联在更严重的总症状(RR:2.19,95%CI:1.48-3.23)、躯体症状(RR:1.52,95%CI:1.15-2.02)、心理症状(RR:1.21,95%CI:1.04-1.42)和泌尿生殖症状(RR:2.11,95%CI:1.39-3.20)方面更为强烈。

结论

儿童期肥胖与 45-49 岁女性更严重的 VMS 或阴道干燥风险增加无关。儿童期肥胖,尤其是腹型肥胖,与更严重的总症状、躯体症状、心理症状和泌尿生殖症状有关。然而,这些症状与绝经之间的关联尚未确定。

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