Matthews K A, Wing R R, Kuller L H, Meilahn E N, Plantinga P
School of Medicine, University of Pittsburgh, Pa.
Arch Intern Med. 1994 Oct 24;154(20):2349-55.
To determine the changes in cardiovascular risk factors and psychological and physical symptoms that occur during the perimenopause.
Cohort study of 541 healthy middle-aged premenopausal women followed up through the menopause.
General community.
After a baseline evaluation taken at study entry, 152 women ceased menstruating for 3 months (not due to surgery) and were not using hormone replacement therapy, and were reevaluated in a similar protocol (perimenopausal examination); 105 of the 152 were evaluated a third time when they had ceased menstruating for 12 months and were not using hormone replacement therapy (postmenopausal examination). One hundred nine premenopausal women who were repeatedly tested constituted a comparison group.
Levels of lipids and lipoproteins, triglycerides, fasting glucose and insulin, blood pressure, weight, height, and standardized measures of psychological symptoms.
Women who became perimenopausal showed increased levels of cardiovascular risk factors, which were similar in magnitude to those experienced by the comparison group of premenopausal women. Perimenopausal women reported a greater number of symptoms, especially hot flashes, cold sweats, joint pain, aches in the skull and/or neck, and being forgetful; reports of hot flashes at the perimenopausal examination were associated with low concentrations of serum estrogens. Menopausal status was not associated with depressive symptoms. Perimenopausal women who became postmenopausal showed a decline in the level of high-density lipoprotein-2-cholesterol (means, 0.53 to 0.43 mmol/L [20.6 to 16.7 mg/dL]) and a gradual increase in the level of low-density lipoprotein cholesterol (means, 3.14 to 3.33 mmol/L [121.3 to 128.8 mg/dL]), whereas symptom reporting declined.
During mid-life, women experience adverse changes in cardiovascular risk factors and a temporary increase in total number of reported symptoms, with no change in depression. Preventive efforts to reduce the menopause-induced increase in cardiovascular risk factors should begin early in the menopausal transition.
确定围绝经期心血管危险因素以及心理和身体症状的变化。
对541名健康的中年绝经前女性进行队列研究，随访至绝经。
普通社区。
在研究开始时进行基线评估后，152名女性停经3个月（非手术原因）且未使用激素替代疗法，并按照类似方案重新评估（围绝经期检查）；152名中的105名在停经12个月且未使用激素替代疗法时进行了第三次评估（绝经后检查）。109名接受多次测试的绝经前女性构成对照组。
脂质和脂蛋白、甘油三酯、空腹血糖和胰岛素水平、血压、体重、身高以及心理症状的标准化测量。
进入围绝经期的女性心血管危险因素水平升高，其幅度与绝经前女性对照组相似。围绝经期女性报告的症状更多，尤其是潮热、冷汗、关节疼痛、颅骨和/或颈部疼痛以及健忘；围绝经期检查时潮热的报告与血清雌激素浓度低有关。绝经状态与抑郁症状无关。进入绝经后的围绝经期女性高密度脂蛋白2胆固醇水平下降（均值，从0.53降至0.43 mmol/L [20.6至16.7 mg/dL]），低密度脂蛋白胆固醇水平逐渐升高（均值，从3.14升至3.33 mmol/L [121.3至128.8 mg/dL]），而症状报告减少。
在中年时期，女性心血管危险因素出现不良变化，报告的症状总数暂时增加，抑郁情况无变化。应在绝经过渡早期开始采取预防措施，以降低绝经引起的心血管危险因素增加。
