Nilsson P, Möller L, Köster A, Hollnagel H
Department of Community Health Sciences, University of Lund, Sweden.
J Intern Med. 1997 Oct;242(4):299-305. doi: 10.1046/j.1365-2796.1997.00220.x.
To investigate possible social, lifestyle-related and biological predictors of early menopause in middle-aged women, followed prospectively for 11 years.
A prospective, population-based, cohort follow-up, observational study.
Glostrup Hospital, Copenhagen, Denmark.
A total of 493 female subjects, all aged 40 years at baseline, and divided into three groups according to self-reported menopausal age (40-45, 46-51, 51+ years), after 12 months of amenorrhoea. Women having had medical or surgical interventions to influence menopausal state were excluded.
Body mass index, glucose, insulin, lipids, creatinine, uric acid, thyroid-stimulating hormone (TSH), lung function tests (forced VC, FEV1, peak flow), blood pressure; a self-administered questionnaire with questions on psychosocial variables, lifestyle, and self-rated health.
An early menopausal age correlated in an univariate way with impaired lung function, increased smoking habits and low social class (in childhood or present), as well as with a feeling of tiredness, all measured at the baseline investigation. On the contrary, a later menopausal age correlated with higher serum insulin and uric acid levels. In multiple regression analysis, with menopausal age as the dependent variable, it was found that smoking habits (number of years smoking) was inversely (P < 0.001), and insulin as well as uric acid were positively (P < 0.05) correlated with menopausal age.
Females who smoke run an increased risk of early menopause, whereas relative hyperinsulinaemia is independently associated with later menopause. At the age of 40 years, high insulin levels in females might be just a marker for normal female sex hormone physiology, not for insulin resistance, as seen in postmenopausal female subjects. Early menopause might be useful as a potential model of premature ageing.
对中年女性进行为期11年的前瞻性随访，调查可能与早绝经相关的社会、生活方式及生物学预测因素。
一项基于人群的前瞻性队列随访观察性研究。
丹麦哥本哈根格洛斯楚普医院。
共有493名女性受试者，基线时年龄均为40岁，在闭经12个月后，根据自我报告的绝经年龄（40 - 45岁、46 - 51岁、51岁以上）分为三组。排除曾接受影响绝经状态的医学或手术干预的女性。
体重指数、血糖、胰岛素、血脂、肌酐、尿酸、促甲状腺激素（TSH）、肺功能测试（用力肺活量、第1秒用力呼气容积、峰值流速）、血压；一份关于心理社会变量、生活方式及自我健康评分的自填式问卷。
在基线调查中，早绝经年龄与肺功能受损、吸烟习惯增加、社会阶层低（童年或当前）以及疲劳感呈单变量相关。相反，绝经年龄较晚与较高的血清胰岛素和尿酸水平相关。在以绝经年龄为因变量的多元回归分析中，发现吸烟习惯（吸烟年数）与绝经年龄呈负相关（P < 0.001），胰岛素和尿酸与绝经年龄呈正相关（P < 0.05）。
吸烟女性早绝经风险增加，而相对高胰岛素血症与绝经年龄较晚独立相关。在40岁时，女性高胰岛素水平可能只是正常女性性激素生理的一个标志，而非绝经后女性受试者中所见的胰岛素抵抗标志。早绝经可能是早衰的一个潜在模型。
