Clinical Psychology and Psychotherapy, University of Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
Clinical Psychology and Psychotherapy, University of Zurich, Switzerland; University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Zurich, Switzerland.
Maturitas. 2024 May;183:107942. doi: 10.1016/j.maturitas.2024.107942. Epub 2024 Feb 21.
Fluctuating estradiol (E2) levels seem to be associated with menopausal symptoms, though not all women suffer from these symptoms to the same extent despite experiencing these hormonal changes. This suggests underlying, interindividual mechanisms, such as single-nucleotide polymorphisms (SNPs) influencing estrogen receptors α and β, and the g-protein-coupled estrogen receptor (GPER). As research is scarce, we aimed to address this research gap by assessing genetic traits, E2 levels, and menopausal symptoms longitudinally.
129 perimenopausal women (aged 40-56 years) participated in the 13-month longitudinal Swiss Perimenopause Study.
Menopausal symptoms were assessed fortnightly using the Menopause Rating Scale (MRS II). Salivary E2 levels were assessed 14 times over two non-consecutive months. Blood samples were collected using the dried blood spot (DBS) technique to analyze ESR1 rs2234693, ESR1 rs9340799, ESR2 rs1256049, ESR2 rs4906938, and GPER rs3808350. Group-based trajectory modeling was performed to identify interindividual trajectories of menopausal symptoms. Multinomial logistic regression models were employed to identify factors associated with these trajectories.
Four distinct trajectory groups of menopausal symptoms were identified (increase, moderate, rebound, decrease). ER gene polymorphisms and E2 fluctuation were significantly associated with group membership. Furthermore, ER gene polymorphisms modulated the effect of E2 fluctuations on menopausal symptom trajectory.
This study illuminates the multifaceted factors contributing to the individuality of the perimenopausal experience. ER gene polymorphisms emerged as integral factors by modulating the effect of E2 fluctuations on menopausal symptom trajectory. This underscores the intricate interplay of genetic factors, E2 fluctuations, and menopausal symptoms during perimenopause.
波动的雌二醇（E2）水平似乎与绝经症状有关，但并非所有女性在经历这些激素变化时都会出现同样程度的这些症状。这表明存在个体间的潜在机制，如影响雌激素受体 α 和 β 的单核苷酸多态性（SNP），以及 G 蛋白偶联雌激素受体（GPER）。由于研究较少，我们旨在通过纵向评估遗传特征、E2 水平和绝经症状来解决这一研究空白。
129 名围绝经期妇女（年龄 40-56 岁）参加了为期 13 个月的瑞士围绝经期研究。
使用绝经评定量表（MRS II）每两周评估一次绝经症状。在两个非连续的两个月内，14 次评估唾液 E2 水平。使用干血斑（DBS）技术采集血样，以分析 ESR1 rs2234693、ESR1 rs9340799、ESR2 rs1256049、ESR2 rs4906938 和 GPER rs3808350。采用基于群组的轨迹建模来识别绝经症状的个体间轨迹。采用多项逻辑回归模型来识别与这些轨迹相关的因素。
确定了 4 种不同的绝经症状轨迹组（增加、中度、反弹、减少）。ER 基因多态性和 E2 波动与组群归属显著相关。此外，ER 基因多态性调节了 E2 波动对绝经症状轨迹的影响。
本研究阐明了导致围绝经期个体体验多样化的多种因素。ER 基因多态性通过调节 E2 波动对绝经症状轨迹的影响，成为重要因素。这突显了遗传因素、E2 波动和围绝经期绝经症状之间的复杂相互作用。
