Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Center of Excellence in Biostatistics, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Sci Rep. 2023 Jun 7;13(1):9274. doi: 10.1038/s41598-023-35934-7.
Postmenopausal status is a risk factor for distal sensory polyneuropathy-the most common type of peripheral neuropathy. We aimed to investigate associations between reproductive factors and history of exogenous hormone use with distal sensory polyneuropathy among postmenopausal women in the United States using data from the National Health and Nutrition Examination Survey 1999-2004, and to explore the modifying effects of ethnicity on these associations. We conducted a cross-sectional study among postmenopausal women aged ≥ 40 years. Women with a history of diabetes, stroke, cancer, cardiovascular disease, thyroid disease, liver disease, weak or failing kidneys, or amputation were excluded. Distal sensory polyneuropathy was measured using a 10-g monofilament test, and a questionnaire was used to collect data on reproductive history. Multivariable survey logistic regression was used to test the association between reproductive history variables and distal sensory polyneuropathy. In total, 1144 postmenopausal women aged ≥ 40 years were included. The adjusted odds ratios were 8.13 [95% confidence interval (CI) 1.24-53.28] and 3.18 (95% CI 1.32-7.68) for age at menarche < 11 years and time since menopause > 20 years, respectively, which were positively associated with distal sensory polyneuropathy; adjusted odds ratios were 0.45 for the history of breastfeeding (95% CI 0.21-0.99) and 0.41 for exogenous hormone use (95% CI 0.19-0.87) were negatively associated. Subgroup analysis revealed ethnicity-based heterogeneity in these associations. Age at menarche, time since menopause, breastfeeding, and exogenous hormone use were associated with distal sensory polyneuropathy. Ethnicity significantly modified these associations.
绝经后状态是远端感觉性多发性神经病（最常见的周围神经病类型）的一个危险因素。我们旨在使用美国国家健康和营养检查调查 1999-2004 年的数据，调查生殖因素和外源性激素使用史与绝经后妇女远端感觉性多发性神经病之间的关系，并探讨种族对这些关系的修饰作用。我们对年龄≥40 岁的绝经后妇女进行了一项横断面研究。患有糖尿病、中风、癌症、心血管疾病、甲状腺疾病、肝病、肾脏功能衰竭或衰弱、或截肢的妇女被排除在外。使用 10 克单丝试验测量远端感觉性多发性神经病，使用问卷收集生殖史数据。多变量调查逻辑回归用于测试生殖史变量与远端感觉性多发性神经病之间的关联。共有 1144 名年龄≥40 岁的绝经后妇女被纳入研究。调整后的优势比分别为 8.13（95%置信区间 1.24-53.28）和 3.18（95%置信区间 1.32-7.68），提示初潮年龄<11 岁和绝经后时间>20 年与远端感觉性多发性神经病呈正相关；哺乳史的调整后优势比为 0.45（95%置信区间 0.21-0.99），外源性激素使用史的调整后优势比为 0.41（95%置信区间 0.19-0.87），与远端感觉性多发性神经病呈负相关。亚组分析显示，这些关联存在基于种族的异质性。初潮年龄、绝经后时间、哺乳和外源性激素使用与远端感觉性多发性神经病相关。种族显著修饰了这些关联。
