CAUSES AND CONSEQUENCES OF EARLY MENOPAUSE

提前绝经的原因和后果

• 批准号: 6289990
• 负责人: GLINDA S COOPER
• 金额: --
• 依托单位: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/6289990
• 关键词: autoimmune disorder; chlorohydrocarbon insecticide; clinical research; dietary carbohydrates; disease /disorder etiology; disease /disorder proneness /risk; epidemiology; female; galactose; human data; human subject; menopause; menstrual cycle; nutrition related tag; ovary disorder; pesticide biological effect; tobacco abuse

Age at menopause has been proposed as a marker of aging and health. Several studies, including one we published using data from the National Health and Examination Survey (NHANES) Epidemiologic Follow-up Study reported increased mortality risk with early natural menopause. Another recent study reported reduced mortality risk among women who gave birth at ages 40 years. We examined the association between reproductive history and mortality in a prospective study involving 18,959 person-years of follow-up and 108 deaths among 826 women. Among parous women, the age- and other covariate-adjusted risk ratio (RR) was 1.5 (95% confidence interval (CI) 0.6 4.1) for natural menopause at ages 45 years compared with 51 years. In contrast to the previous report, however, the highest estimated mortality risk was seen in women with a birth in their 40s (adjusted RR 2.1, 95% CI 1.1 4.4) compared with last birth between ages 30 34 years). We also used data from this study to examine smoking in relation to natural menopause in 543 women who prospectively recorded menstrual data from their 20s through their menopause. Mean age at natural menopause was 0.8 years younger (95% CI 1.5, 0.0) in 98 women who smoked at menopause compared with 362 never- smokers (RR 1.3, 95% CI 1.0 1.7). We did not observe a decrease in age at natural menopause in former smokers, a dose-response among current smokers, or a lower age at menopause with passive smoke exposure at home. These results suggest that the effect of smoking on ovarian senescence is limited to active smoking during the menopausal transition. The National Health and Nutrition Examination Survey (NHANES) III, conducted from 1988-1994 provides an opportunity to examine specific medical and behavioral risk factors for early menopause. We examined correlates of follicle-stimulating hormone (FSH), a gonadotropin that can be used as a measure of menopausal status in a sample of 1716 women ages 35 to 49 in the NHANES-III data. Hysterectomy with unilateral oophorectomy was associated with an increased prevalence of elevated FSH (above 20 IU/L) (adjusted odds ratio (OR) 2.4, 95% CI 1.3 4.6) compared with women who had not had a hysterectomy or oophorectomy. Among women with two ovaries, hysterectomy was associated with an increased prevalence of elevated FSH (adjusted OR 1.5, 95% CI 1.0 2.5). As a comparison of the effect size, the observed association between hysterectomy and elevated FSH is smaller than the association between FSH and current smoking (OR 2.0), a factor that is associated with a 1 2 year decrease in mean age at natural menopause. - longitudinal studies, premature ovarian failure, menopause, risk factors, sex hormones, galactose, tobacco smoke, polymorphism - Human Subjects & Human Subjects: Interview, Questionaires, or Surveys Only

更年期的年龄已被认为是衰老和健康的标志。几项研究，包括我们使用国家卫生和考试调查（NHANES）流行病学后续研究的数据发表的一项研究报告说，早期自然更年期的死亡风险增加。最近的另一项研究报告说，在40岁时出生的妇女死亡风险降低。我们研究了一项涉及18,959人的随访年度和826名妇女死亡的前瞻性研究中生殖历史与死亡率之间的关联。在众多妇女中，年龄和其他协变量调整后的风险比率（RR）为1.5（95％的置信区间（CI）0.6 4.1），年龄在45岁之间的自然更年期为51岁。然而，与先前的报告相反，与30 34岁年龄段的最后出生相比，在40多岁时出生的女性（调整后的RR 2.1，95％CI 1.1 4.4），估计死亡率的最高风险是最高的。我们还使用了这项研究的数据来检查543名妇女的自然更年期吸烟，这些女性前瞻性地记录了20多岁的月经数据。自然更年期的平均年龄年龄较小0.8岁（95％CI 1.5，0.0），与362名无吸烟者相比，在更年期吸烟的妇女中的平均年龄为98名女性（RR 1.3，95％CI 1.0 1.0 1.7）。我们没有观察到以前吸烟者自然更年期的年龄下降，当前吸烟者的剂量反应或更年期的较低年龄，而在家中被动烟雾。这些结果表明，吸烟对卵巢衰老的影响仅限于在更年期过渡期间的积极吸烟。 1988 - 1994年进行的国家健康和营养检查调查（NHANES）III提供了一个机会，可以检查更年期早期的特定医疗和行为风险因素。我们检查了促卵泡激素（FSH）的相关性，这是一种促性腺激素，可以用作NHANES-III数据中1716名35至49岁的女性的绝经状态的量度。子宫切除术和单侧卵巢切除术与FSH升高（高于20 IU/L）的患病率增加（调整后的优势比（OR）2.4，95％CI 1.3 4.6）相比，与没有子宫切除术或卵形切除术的女性相比。在两个卵巢的女性中，子宫切除术与FSH升高的患病率升高（调整后或1.5，95％CI 1.0 2.5）。作为效应大小的比较，观察到的子宫切除术和升高的FSH之间的关联小于FSH和当前吸烟（OR 2.0）之间的关联，这是自然更年期平均年龄降低1 2年的因素。 - 纵向研究，早产卵巢衰竭，更年期，危险因素，性激素，半乳糖，烟草烟雾，多态性 - 人类受试者和人类受试者：访谈，问题或调查