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更年期激素治疗与肌肉减少性肥胖:加拿大老龄化纵向研究

Menopause hormone therapy and sarcodynapenia: the Canadian Longitudinal Study on Aging.

作者信息

Câmara Saionara M A, Macêdo Pedro R S, Velez Maria P

机构信息

From the Postgraduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Avenida Senador Salgado Filho, Natal, Rio Grande do Norte, Brazil.

Department of Obstetrics and Gynecology, Queen's University, Kingston, Ontario, Canada.

出版信息

Menopause. 2023 Mar 1;30(3):254-259. doi: 10.1097/GME.0000000000002127. Epub 2022 Dec 19.

Abstract

OBJECTIVE

To study the association between menopause hormone therapy (MHT) and sarcodynapenia in women from the Canadian Longitudinal Study on Aging.

METHODS

We conducted a cross-sectional study of 10,834 eligible postmenopausal women. The exposure was prior or current use of MHT (never, ever). Sarcopenia was defined as an appendicular lean mass less than 5.72 kg/m 2 using dual-energy X-ray absorptiometry, and dynapenia as a grip strength less than 20.4 kg. Sarcodynapenia was defined as the concomitant presence of sarcopenia and dynapenia. Poisson regression analysis produced prevalence ratios (PR) for the associations between MHT use and sarcodynapenia adjusted for age at interview, education, study site, smoking, diabetes, hypertension, and body mass index. Additional analyses were conducted according to duration of MHT (5 years or less, more than 5 years), age categories (45-64 years, 65 years or older), and physical activity level as per the Physical Activity Scale for the Elderly score (less active, more active).

RESULTS

Menopause hormone therapy was not associated with sarcodynapenia (PR, 1.10; 95% CI, 0.89-1.35). When subdivided by years of use and physical activity, relative to no MHT use, MHT use for 5 years or less was associated with a higher prevalence of sarcodynapenia among less active women (PR, 1.57; 95% CI, 1.11-2.21) and with a lower prevalence among those more active (PR, 0.60; 95% CI, 0.39-0.92). The use of MHT for more than 5 years was not associated with sarcodynapenia.

CONCLUSIONS

Menopause hormone therapy for 5 years or less is associated with a lower prevalence of sarcodynapenia among physically active women and with a higher prevalence of sarcodynapenia in those less active. Strategies to promote an active lifestyle in all postmenopausal women, including MHT users, are needed to attain benefits for musculoskeletal health.

摘要

目的

在加拿大老龄化纵向研究中,研究绝经激素治疗(MHT)与女性肌少力性肌减少症之间的关联。

方法

我们对10,834名符合条件的绝经后女性进行了横断面研究。暴露因素为既往或当前使用MHT(从未使用、曾经使用)。使用双能X线吸收法将肌少症定义为四肢瘦体重低于5.72kg/m²,将肌肉力量减退定义为握力低于20.4kg。肌少力性肌减少症定义为同时存在肌少症和肌肉力量减退。泊松回归分析得出MHT使用与肌少力性肌减少症之间关联的患病率比(PR),并根据访谈时年龄、教育程度、研究地点、吸烟、糖尿病、高血压和体重指数进行了调整。根据MHT使用时长(5年或更短、超过5年)、年龄类别(45 - 64岁、65岁及以上)以及根据老年人身体活动量表评分得出的身体活动水平(活动较少、活动较多)进行了额外分析。

结果

绝经激素治疗与肌少力性肌减少症无关(PR,1.10;95%CI,0.89 - 1.35)。按使用年限和身体活动情况细分时,相对于未使用MHT,使用MHT 5年或更短时间与活动较少的女性中肌少力性肌减少症患病率较高相关(PR,1.57;95%CI, 1.11 - 2.21),而与活动较多的女性中患病率较低相关(PR,0.60;95%CI, 0.39 - 0.92)。使用MHT超过5年与肌少力性肌减少症无关。

结论

使用5年或更短时间的绝经激素治疗与身体活动活跃的女性中较低的肌少力性肌减少症患病率相关,而与活动较少的女性中较高的患病率相关。需要采取策略来促进所有绝经后女性(包括使用MHT的女性)养成积极的生活方式,以实现肌肉骨骼健康方面的益处。

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