绝经还是年龄增长的影响？——一项针对中年女性冠心病高危因素的前瞻性队列研究

Background??Menopause will cause series of pathophysiologic changes and long-term complicationscoronary heart diseasecerebrovascular diseaseosteoporosisetc.among which coronary heart disease is the top killer of health. Objective ?To investigate the effects of menopausal status and aging on common risk factors for coronary heart diseaseCHDin middle-aged womensuch as increased carotid intima-media thicknessCIMThypertensiondyslipidemiadiabetesand obesity. Methods ?A total of 556 healthy premenopausal women aged 45 to 54 years who received regular physical examinations at the physical examination center of Beijing Shijitan Hospital affiliated to Capital Medical University in 2018 were initially selectedwith 89 excluded according to relevant criteriaand 467 women were finally included as study subjects. The included subjects were divided into the pre-menopausal groupn=176and postmenopausal groupn=291according to whether they were postmenopausal during a 3-year follow-up period. Changes in BMIwaist circumferenceblood glucoseblood pressureblood lipids and other indicators were monitoredinter- and intra-group comparisons were performed before and after the follow-up period. Multivariate logistic regression analysis was used to explore the effects of menopausal status and age on the incidence of risk factors for coronary heart disease in middle-aged women. Results ?The average age of 467 subjects was 47.6±2.3years old. Compared with baselinewaist circumferenceuric acidUAtotal cholesterolTCtriglycerideTGand low density lipoprotein cholesterolLDL-Clevels increasedfasting blood glucoseFBGlevel decreased after 3 yearsP<0.05. The results of inter-group comparison showed that there was no significant difference in waist circumferenceBMITGFBG and high density lipoprotein cholesterolHDL-Clevels between the two groups after three yearsP<0.05the levels of UATC and LDL-C in the menopausal group were higher than those in the pre-menopausal groupand the difference was statistically significantP<0.05. The results of intra-group comparison showed that the waist circumference in the two groups after 3 years was higher than baselineP<0.05the levels of UATC and TG in the pre-menopausal group after 3 years were higher than the baselineP<0.05the levels of UATCTG and LDL-C in the postmenopausal group after 3 years were higher than the baselineP<0.05. Multivariate Logistic regression analysis showed that age ≥ 50 years old was a high-risk factor for increased CIMT in middle-aged womenOR=2.47595%CI=1.049-5.838P=0.038. Conclusions ?The changes in waist circumference and TG in middle-aged women are mainly affected by agethe changes of LDL-C are mainly affected by menopausal statusand the changes of TC and UA are affected by both menopausal status and increased age. Age≥50 years is a high risk factor for increased CIMT in middle-aged womenand the changes of metabolic indicators such as UATC and LDL-C precede changes in CIMT after menopause.