National Human Genetic Resources Center, National Research Institute for Family Planning, Beijing, China.
Graduate School of North, China University of Science and Technology, Tangshan, China.
BMC Womens Health. 2024 Sep 11;24(1):504. doi: 10.1186/s12905-024-03344-0.
Menopause significantly impacts the immune system. Postmenopausal women are more susceptible to infection. Nonetheless, the pattern of change in peripheral white blood cell counts around the menopause remains poorly understood.
We conducted a prospective longitudinal cohort study with repeated measurements using Kailuan cohort study of 3632 Chinese women who participated in the first checkup (2006-2007) and reached their final menstrual period (FMP) by the end of the seventh checkup (2018-2020). Peripheral WBC count indicators included total white blood cells (TWBC), neutrophils (NEUT), lymphocytes (LYM), and monocytes (MON). Multivariable mixed effects regressions fitted piece-wise linear models to repeated measures of WBC count indicators as a function of time before or after the final menstrual period (FMP). Interaction and subgroup analysis were used to explore the effects of age and body mass index (BMI) on changes in WBC indicators around FMP.
WBC count indicators decreased before the FMP, and the reduction in TWBC, NEUT, and MON continued for 2 years following the FMP. LYM and NEUT declined during < -1 years and - 4 ∼ + 2 years relative to FMP, respectively. A reduction in MON was observed pre-FMP, extending continuously through the two-year period post-FMP. TWBC declined from - 3 to + 2 years relative to FMP, but both MON and TWBC increased during > + 2 years. The baseline age had an interaction effect on changes in WBC indicators during specific menopausal stages, except for TWBC. Individuals in different age subgroups showed distinct trajectories for NEUT, LYM and MON around the FMP. High baseline BMI had a synergistic effect on changes in specific menopause segments for TWBC, LYM, and MON. The impact of menopause on TWBC and LYM was postponed or counterbalanced in high BMI individuals. Individuals in three BMI subgroups experienced similar MON changes around FMP, and there were slight variations during < -4 years.
Menopause was associated with count changes of peripheral WBC. The trajectories of various WBC types differ around menopause. Age and BMI affected WBC trajectory around menopause. The menopause period may represent a window of opportunity to promote immune health in middle-aged women.
绝经显著影响免疫系统。绝经后女性更容易感染。然而，绝经前后外周血白细胞计数变化模式仍知之甚少。
我们进行了一项前瞻性纵向队列研究，使用 Kailuan 队列研究的 3632 名中国女性进行重复测量，这些女性参加了第一次体检（2006-2007 年），并在第七次体检结束时（2018-2020 年）达到了最后一次月经（FMP）。外周血白细胞计数指标包括总白细胞计数（TWBC）、中性粒细胞（NEUT）、淋巴细胞（LYM）和单核细胞（MON）。多变量混合效应回归分析采用分段线性模型，将 WBC 计数指标作为 FMP 前后时间的函数进行重复测量。采用交互和亚组分析探讨年龄和体重指数（BMI）对 FMP 前后 WBC 指标变化的影响。
在 FMP 前，白细胞计数指标下降，TWBC、NEUT 和 MON 在 FMP 后持续下降 2 年。LYM 和 NEUT 在 FMP 前分别下降了-1 年和-4 年至+2 年。在 FMP 前观察到 MON 减少，并持续到 FMP 后两年。TWBC 从 FMP 前的-3 年下降到+2 年，但 MON 和 TWBC 在+2 年以上均增加。除 TWBC 外，基线年龄对特定绝经期阶段 WBC 指标变化有交互作用。不同年龄亚组在 FMP 前后的 NEUT、LYM 和 MON 呈现出不同的轨迹。高基线 BMI 对 TWBC、LYM 和 MON 特定绝经期段的变化有协同作用。高 BMI 个体的绝经对 TWBC 和 LYM 的影响被推迟或抵消。在三个 BMI 亚组中，FMP 前后 MON 变化相似，在-4 年之前略有差异。
绝经与外周血白细胞计数变化有关。各种白细胞类型在绝经期周围的轨迹不同。年龄和 BMI 影响绝经前后的 WBC 轨迹。绝经期可能是促进中年女性免疫健康的一个机会窗口。
