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生殖阶段是否会影响心血管疾病的危险因素?来自洛桑(CoLaus 研究)的一项基于人群的队列研究结果。

Does reproductive stage impact cardiovascular disease risk factors? Results from a population-based cohort in Lausanne (CoLaus study).

机构信息

Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.

Swiss Paraplegic Research, Nottwil, Switzerland.

出版信息

Clin Endocrinol (Oxf). 2022 Nov;97(5):568-580. doi: 10.1111/cen.14730. Epub 2022 Apr 15.

Abstract

CONTEXT

Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying ageing trajectories.

DESIGN

The CoLaus study is a prospective population-based cohort study in Lausanne, Switzerland.

PATIENTS

We used data from women at baseline and follow-up (mean: 5.6 ± 0.5 years) from 2003 to 2012 who did not use hormone therapy. We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years) and (iv) late (>5 years) postmenopausal by comparing their menstruation status at baseline and follow-up.

MEASUREMENTS

We measured fasting lipids, glucose and cardiovascular inflammatory markers. We used repeated measures (linear mixed models) for longitudinal analysis, using premenopausal women as a reference category. We adjusted analyses for age, medications and lifestyle factors.

RESULTS

We used the data from 1710 women aged 35-75 years. Longitudinal analysis showed that the changes in CVD risk factors were not different in the other three menopausal categories compared to premenopausal women. When age was used as a predictor variable and adjusted for menopause status, most CVD risk factors increased, while interleukin-6 and interleukin-1β decreased with advancing age.

CONCLUSION

The current study suggests that women have a worsening cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the 5-year changes in cardiovascular risk factors may not depend on the reproductive stage.

摘要

背景

绝经与不良心血管疾病(CVD)风险状况相关,但尚不清楚 CVD 风险因素的变化是否独立于潜在的衰老轨迹,因生殖阶段而异。

设计

CoLaus 研究是瑞士洛桑的一项前瞻性基于人群的队列研究。

患者

我们使用了 2003 年至 2012 年期间基线和随访(平均:5.6±0.5 年)时未使用激素治疗的女性的数据。我们通过比较基线和随访时的月经状况,将女性分为(i)绝经前,(ii)绝经过渡期,(iii)早期(≤5 年)和(iv)晚期(>5 年)绝经后。

测量

我们测量了空腹血脂、血糖和心血管炎症标志物。我们使用重复测量(线性混合模型)进行纵向分析,以绝经前女性为参考类别。我们调整了分析以考虑年龄、药物和生活方式因素。

结果

我们使用了来自 1710 名年龄在 35-75 岁之间的女性的数据。纵向分析表明,与绝经前女性相比,其他三个绝经类别中 CVD 风险因素的变化没有差异。当使用年龄作为预测变量并根据绝经状态进行调整时,大多数 CVD 风险因素增加,而白细胞介素-6 和白细胞介素-1β随着年龄的增长而下降。

结论

目前的研究表明,女性随着年龄的增长心血管风险状况恶化,尽管在任何特定时间绝经女性的心血管风险因素水平可能高于绝经前女性,但 5 年内心血管风险因素的变化可能不依赖于生殖阶段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a68/9790265/ff18e9b13854/CEN-97-568-g001.jpg

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