摘要
目的：在45-59岁中国女性人群中,探索绝经与心血管疾病及相关代谢紊乱的关联关系。方法：将中国健康与养老追踪调查（China health and retirement longitudinal study,CHARLS）2013年第1次随访调查具有全国代表性的横断面调查样本中4 702名45-59岁围绝经期女性选出作为研究对象,其中未绝经女性1 769人,已绝经女性2 933人。主要研究变量来自于健康状况和功能问卷以及体格测量结果,采用广义线性模型计算并比较未绝经和已绝经两组人群心血管危险因素经过年龄等因素调整后的均值;采用多变量Logistic回归模型调整年龄等混杂因素,计算绝经与心血管疾病及其危险因素之间的OR值及95%可信区间。结果：调整年龄和其他混杂因素后,发现绝经与心血管疾病有正向关联（OR=1.34,95%CI：1.04-1.74）;绝经与高血压（OR=1.42,95%CI：1.10-1.84）、绝经与同时具有2种及以上心血管危险因素（OR=1.31,95%CI：1.02-1.68）的关联也具有统计学意义;此外,已绝经女性人群的腰围平均水平（87.11 cm,95%CI：86.81-87.42 cm）高于未绝经人群（86.41 cm,95%CI：85.99-86.84 cm）;研究未发现绝经与糖尿病及血糖升高、血脂异常、肥胖的统计学关联。结论：中国女性绝经后更可能具备一种或多种心血管危险因素,从而具备更高的心血管疾病发病风险,绝经可能在老龄化的影响之外进一步加剧中老年女性人群的心血管相关疾病负担。
Objective： To explore the associations of menopause with cardiovascular disease（ CVD）and related metabolic disorders（ including hypertension,diabetes or higher blood sugar,obesity,dyslipidemia） in Chinese females aged 45- 59 years. Methods： Data were acquired from a national crosssectional survey conducted in 2013,China,which was also the second follow-up survey of China Health and Retirement Longitudinal Study（ CHARLS）. In the study,4 702 Chinese perimenopausal women aged 45- 59 years were enrolled,including 1 769 premenopausal women and 2 933 postmenopausal women. Information was collected from questionnaires of health status and functioning and physical examination. General liner models were employed to calculate age-adjusted or age-and-body-mass-indexadjusted or multiple-factor-adjusted means and their 95% confidence intervals（ 95% CIs） of cardiovascular risk factors（ CRFs）. The comparisons of CVD and its risk factors according to menopausal status,and calculation of adjusted odds ratios（ ORs） and their 95% CIs for the associations of menopause with CVD and its risk factors were performed by multivariate Logistic regression models separately. Results：After adjustment for age and other confounders（ including body mass index,marriage,education,current smoking,drink alcohol more than once per month）,statistically significant associations of menopause with cardiovascular disease,which referred to having a history of heart disease or stroke in this study,were observed in the participants（ OR = 1. 34,95% CI： 1. 04- 1. 74）; prevalence of hypertension（ OR =1. 42,95% CI： 1. 10- 1. 84）,prevalence of CRFs clustering number≥2（ OR = 1. 31,95% CI：1. 02- 1. 68） and average waist circumference level（ 87. 11 cm,95% CI： 86. 81- 87. 42 cm in postmenopausal group vs. 86. 41 cm,95% CI： 85. 99- 86. 84 cm in premenopausal group） were presented higher in postmenopausal group,compared with the premenopausal one. However,diabetes or higher blood sugar（ OR = 0. 96,95% CI： 0. 60- 1. 52）,dyslipidemia（ OR = 0. 84,95% CI： 0. 59- 1. 20）and obesity（ OR = 1. 06,95% CI： 0. 86- 1. 32） were not shown significantly statistically related to menopause,after excluding effect of age and other confounders. Conclusion： Postmenopausal women in China had worse CRFs profile than the premenopausal ones,which implied menopause might aggravate the CRFs epidemic and increase the risk of cardiovascular disease beyond effects of aging,which would increase the CVD burden during and after their middle ages.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2016年第3期448-453,共6页
Journal of Peking University:Health Sciences
基金
国家自然科学基金(81573226
81230066)
北京市自然科学基金(7162107)资助~~
关键词
围绝经期
心血管疾病
代谢疾病
Perimenopause
Cardiovascular disease
Metabolic diseases
