Self-reported menopausal symptoms, coronary artery calcification, and carotid intima-media thickness in recently menopausal women screened for the Kronos early estrogen prevention study (KEEPS)

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• 作者：Erin Foran Wolff ; M.D.^a ; ^{wolffe@mail.nih.gov} ; Yunxiao He ; Ph.D.^b ; Dennis M. Black ; Ph.D.^c ; Eliot A. Brinton ; M.D. ; F.A.H.A. ; F.N.L.A.^d ; Mathew J. Budoff ; M.D.^e ; Marcelle I. Cedars ; M.D.^c ; Howard N. Hodis ; M.D.^f ; Rogerio A. Lobo ; M.D.^g ; JoAnn E. Manson ; M.D. ; Dr.P.H.^h ; George R. Merriam ; M.D.ⁱ ; Virginia M. Miller ; Ph.D.^j ; Fredrick Naftolin ; M.D. ; Ph.D.^k ; Lubna Pal ; M.B. ; B.S. ; M.S.^b ; Nanette Santoro ; M.D.^l ; Heping Zhang ; Ph.D.^b ; S. Mitchell Harman ; M.D. ; Ph.D.^m ; Hugh S. Taylor ; M.D.^b
• 关键词：KEEPS ; estrogen ; cardiovascular ; menopause ; CAC ; CIMT ; palpitations ; depression
• 刊名：Fertility and Sterility
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：99
• 期：5
• 页码：1385-1391
• 全文大小：173 K

文摘

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Objective

To determine whether self-reported menopausal symptoms are associated with measures of subclinical atherosclerosis.

Design

Cross-sectional analysis.

Setting

Multicenter, randomized controlled trial.

Patient(s)

Recently menopausal women (n = 868) screened for the Kronos Early Estrogen Prevention Study (KEEPS).

Intervention(s)

None.

Main Outcome Measure(s)

Baseline menopausal symptoms (hot flashes, dyspareunia, vaginal dryness, night sweats, palpitations, mood swings, depression, insomnia, irritability), serum E₂ levels, and measures of atherosclerosis were assessed. Atherosclerosis was quantified using coronary artery calcium (CAC) Agatston scores (n = 771) and carotid intima-media thickness (CIMT). Logistic regression model of menopausal symptoms and E₂ was used to predict CAC. Linear regression model of menopausal symptoms and E₂ was used to predict CIMT. Correlation between length of time in menopause with menopausal symptoms, E₂, CAC, and CIMT were assessed.

Result(s)

In early menopausal women screened for KEEPS, neither E₂ nor climacteric symptoms predicted the extent of subclinical atherosclerosis. Palpitations and depression approached significance as predictors of CAC. Other symptoms of insomnia, irritability, dyspareunia, hot flashes, mood swings, night sweats, and vaginal dryness were not associated with CAC. Women with significantly elevated CAC scores were excluded from further participation in KEEPS; in women meeting inclusion criteria, neither baseline menopausal symptoms nor E₂ predicted CIMT. Years since menopause onset correlated with CIMT, dyspareunia, vaginal dryness, and E₂.

Conclusion(s)

Self-reported symptoms in recently menopausal women are not strong predictors of subclinical atherosclerosis. Continued follow-up of this population will be performed to determine whether baseline or persistent symptoms in the early menopause are associated with progression of cardiovascular disease.

Clinical Trial Registration Number

.