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绝经激素治疗:澳大利亚全国横断面研究中的使用者特征。

Menopausal hormone therapy: Characterising users in an Australian national cross-sectional study.

机构信息

Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Woolloomooloo, Sydney, New South Wales, Australia.

Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, Victoria, Australia.

出版信息

PLoS One. 2021 Aug 11;16(8):e0253725. doi: 10.1371/journal.pone.0253725. eCollection 2021.

Abstract

Menopausal hormone therapy (MHT) is effective for menopausal symptoms, however, its use is also associated with risks of serious health conditions including breast, ovarian and endometrial cancer, stroke and venous thromboembolism. MHT-related health risks increase with longer durations of use. In Australia, while overall MHT use fell when risk-related findings were published in 2002, a significant number of women continue using MHT long-term. We aimed to examine socio-demographic, health-related and lifestyle characteristics in relation to post-2002 MHT use, and to compare use for <5 and ≥5 years. Data from 1,561 participants from an Australian, national, cross-sectional survey of women aged 50-69 in 2013 were analysed. Odds ratios (ORs) were calculated using logistic regression for characteristics related to overall MHT use post-2002 and multinomial logistic regression for associations between MHT duration of use [never/<5 years/≥5 years] and personal characteristics, adjusting for sociodemographic, reproductive, health and lifestyle factors. Post-2002 MHT use was associated with increasing age (p-trend<0.001), hysterectomy versus no hysterectomy (OR:2.55, 95%CI = 1.85-3.51), bilateral oophorectomy vs no oophorectomy (OR:1.66, 95%CI = 1.09-2.53), and ever- versus never-use of therapies other than MHT for menopausal symptoms (OR:1.93, 95%CI = 1.48-2.57). Women with prior breast cancer (OR:0.35, 95%CI = 0.17-0.74) and with more children (p-trend = 0.034) were less likely than other women to use MHT. Prior hysterectomy was more strongly associated with MHT use for ≥5 years than for <5 years (p = 0.004). Ever-use of non-MHT menopausal therapies was associated with MHT use for <5 years but not with longer-term use (p = 0.004). This study reinforces the need for MHT users and their clinicians to re-evaluate continued MHT use on an ongoing basis.

摘要

绝经激素治疗(MHT)对缓解绝经症状有效,但也与乳腺癌、卵巢癌和子宫内膜癌、中风和静脉血栓栓塞等严重健康状况的风险相关。MHT 相关健康风险随使用时间的延长而增加。在澳大利亚,2002 年发布与风险相关的研究结果后,MHT 的总体使用量有所下降,但仍有相当数量的女性长期使用 MHT。我们旨在研究 2002 年后与 MHT 使用相关的社会人口统计学、健康相关和生活方式特征,并比较使用时间<5 年和≥5 年的情况。对 2013 年澳大利亚一项针对 50-69 岁女性的全国性横断面调查的 1561 名参与者进行了数据分析。使用逻辑回归计算 2002 年后总体 MHT 使用相关特征的比值比(OR),使用多项逻辑回归分析 MHT 使用持续时间[从未/使用<5 年/使用≥5 年]与个人特征之间的关系,同时调整社会人口统计学、生殖、健康和生活方式因素。2002 年后使用 MHT 与年龄增长呈正相关(p 趋势<0.001)、与子宫切除术(OR:2.55,95%CI = 1.85-3.51)、双侧卵巢切除术(OR:1.66,95%CI = 1.09-2.53)、除 MHT 外使用其他治疗方法(OR:1.93,95%CI = 1.48-2.57)与绝经症状呈正相关。与其他女性相比,既往患有乳腺癌(OR:0.35,95%CI = 0.17-0.74)和生育子女较多(p 趋势=0.034)的女性使用 MHT 的可能性较小。既往子宫切除术与 MHT 使用时间<5 年比使用时间≥5 年的相关性更强(p=0.004)。除 MHT 外使用绝经相关治疗方法与 MHT 使用时间<5 年相关,但与使用时间≥5 年无关(p=0.004)。本研究进一步证实,MHT 使用者及其临床医生需要定期重新评估是否继续使用 MHT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd92/8357145/71e65ba73026/pone.0253725.g001.jpg

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