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JCEM:早绝经女性易患心脏病和骨质疏松症

2013-03-20 伊文 医师报

骨质疏松症绝经女性
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　　福建医科大学福建省立医院内分泌科陈刚教授等开展的一项大型横断面研究表明，在我国女性中，月经初潮和绝经年龄较晚（分别≥ 18 岁和>53 岁）者罹患心血管病（CVD）的风险降低，而早绝经（≤ 46 岁）可致骨质疏松症风险升高，但月经初潮和绝经年龄均与糖尿病无关。（JClin Endocrinol Metab. 

　　福建医科大学福建省立医院内分泌科陈刚教授等开展的一项大型横断面研究表明，在我国女性中，月经初潮和绝经年龄较晚（分别≥ 18 岁和>53 岁）者罹患心血管病（CVD）的风险降低，而早绝经（≤ 46 岁）可致骨质疏松症风险升高，但月经初潮和绝经年龄均与糖尿病无关。（JClin Endocrinol Metab. 2013 年3月7 日在线版）　　

　　在初步纳入的6242 例年龄为21~92 岁的女性受试者中，该研究入选了其中3304 例绝经后女性。受试者入选后接受口服葡萄糖耐量试验（OGTT）、12导联静息心电图和跟骨定量超声检查。

　　结果显示，月经初潮年龄与糖尿病和骨质疏松症无关。然而，与月经初潮年龄<16 岁者相比，月经初潮年龄≥ 18 岁者罹患CVD的风险显著降低（OR=0.71，P=0.002）；随着月经初潮年龄延后，CVD 风险呈下降趋势。

　　研究者发现，绝经年龄与糖尿病也无明显关联，这有别于2012 年发表的一项前瞻性病例队列研究结果。后者表明，40 岁以前绝经者罹患2 型糖尿病的风险显著增加，且绝经年龄每提前1岁，糖尿病风险增加8%（DiabetesCare.2012 年12 月10 日在线版）。

　　与50 岁时绝经者相比，我国46 岁以前绝经者出现骨质疏松症的风险显著升高（OR=1.59，P=0.023， 表1）。随着绝经年龄延后，CVD 和骨质疏松症风险均呈降低趋势。于2012 年发表的MESA 研究表明，早绝经（46 岁以前）的女性罹患冠心病和卒中的风险是正常年龄绝经女性的2 倍（Menopause.2012,19:1081）。该研究既包括白人，也纳入了华裔和黑人受试者。

　　

 

　　研究者观点

　　目前， 全世界的中位月经初潮年龄为12 岁，在本研究中我国女性的月经初潮年龄为12.4岁。较早出现月经初潮的女性成年后体质指数和腰围数值均较高，说明这些女性需要进行生活方式调节，以预防腹型肥胖、糖尿病和CVD。研究者表示，该研究将有助于制定CVD、骨质疏松症等疾病的人群预防策略。

与骨质疏松相关的拓展阅读：


Context
Ages at menarche and menopause are associated with cardiovascular disease (CVD), diabetes, and osteoporosis in Caucasian women, but associations remain unexplored in Chinese women.
Objective
The purpose of this study was to assess associations between age at menarche and menopause with CVD, diabetes, and osteoporosis in Chinese women.
Design and Setting: A cross-sectional, population-based study was conducted in Fujian, China, from June 2011 to January 2012.
Participants
Among 6242 women aged 21 to 92 years, 3304 postmenopausal women were enrolled, excluding premenopausal women (n = 2527), those with unreported ages at menarche and menopause (n = 138), those with unrecorded physical measurements (n = 203), and those with menarche age <8 years or >20 years (n = 70).
Main Outcome Measures
An oral glucose tolerance test, a 12-lead resting electrocardiogram, and calcaneus quantitative ultrasound were performed.
Results
No significant associations were found between menarche age, diabetes, and osteoporosis (both P > .05); later menarche (>18 years) was significantly associated with lower CVD risk (odds ratio = 0.71, 95% confidence interval, 0.57–0.89; P = .002). Menopause age was not associated with diabetes; higher menopause age was associated with decreasing CVD risk (P for trend = .020) and earlier menopause (≤46 years) with significantly higher osteoporosis risk (odds ratio = 1.59, 95% confidence interval, 1.07–2.36; P = .023).
Conclusions
In China, ages at menarche and menopause are not associated with diabetes. Later menarche and menopause are associated with decreasing CVD risk and earlier menopause with higher osteoporosis risk. Menarche and menopause history may help identify women with increased risk of developing CVD and osteoporosis.

    

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    2013-04-09 achengzhao

    #JCE#

    0

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    2013-10-06 smallant2015

    #JCEM#

    0

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    2013-03-22 yeye5224612

    #绝经#

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    2013-03-22 zhucaizhong7771

    #绝经女性#

    0

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    2013-03-22 Eleven17

    #骨质#

    0

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PNAS：卵泡刺激素多克隆抗体治愈骨质疏松症

一项新的研究表明相比现有的预防或治疗骨质疏松症方法，阻断卵泡刺激素（FSH）的多克隆抗体对卵巢摘除小鼠可能会??是一种更有效的治疗手段这项研究使用更年期的小鼠模型注射多克隆抗肽抗体发现在减缓骨质的破坏同时也能促进骨的再生。此外，西奈山医学院的研究人员证实单克隆抗体可能是更安全的，因为它能从血液中清除，并不残留在骨中。 研究结果发表在8月20日的PNAS杂志上。Zaidi研究团队开发的FSH多克隆

口服降钙素预防绝经后骨质疏松症II期试验获阳性结果

ASBMR2012年会上的口头报告显示TARSA的口服降钙素片达到了疗效终点且安全性良好。在ASBMR 2012年会展出的板报中，使用TARSA的口服降钙素一年的结论是与患癌症风险增加无关。Tarsa Therapeutics公司近日宣布，其产品口服重组鲑鱼降钙素预防绝经后骨质疏松症的II期临床试验成功结束，并取得了统计学上显著意义的结论，腰椎的骨密度（BMD）获得了临床改善。这些数据是Neil

J Proteome Res：科学家解决吸烟弱化骨骼之谜

自科学??家们首次发现吸烟为骨质疏松症和骨折的危险因素20年后，今日，一项新的研究阐明了香烟烟雾是如何削弱骨骼的。相关研究论文发表在Journal of Proteome Research研究杂志上，该研究报告得出结论认为香烟烟雾使人们产生促发身体自然存在的破骨行为的一种过量的蛋白质。 Gary Guishan Xiao和他的同事指出，以往的研究表明香烟烟雾中毒素通过影响成骨细胞削弱骨骼，成

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