Association of menopausal characteristics and risk of coronary heart disease: a pan-European case-cohort analysis

被引：67

作者：

Dam, Veerle ^{[1
,2
]}

van Der Schouw, Yvonne T. ^{[1
]}

Onland-Moret, N. Charlotte ^{[1
]}

Groenwold, Rolf H. H. ^{[1
]}

Peters, Sanne A. E. ^{[3
]}

Burgess, Stephen ^{[4
,5
]}

Wood, Angela M. ^{[5
]}

Chirlaque, Maria-Dolores ^{[6
,7
]}

Moons, Karel G. M. ^{[1
]}

Oliver-Williams, Clare ^{[8
,9
]}

Schuit, Ewoud ^{[1
]}

Tikk, Kaja ^{[10
,11
]}

Weiderpass, Elisabete ^{[12
,13
,14
,15
]}

Holm, Marianne ^{[16
]}

Tjonneland, Anne ^{[16
]}

Kuehn, Tilman ^{[17
]}

Fortner, Renee T. ^{[17
]}

Trichopoulou, Antonia ^{[18
,19
]}

Karakatsani, Anna ^{[18
,20
]}

La Vecchia, Carlo ^{[18
,21
]}

Ferrari, Pietro ^{[22
]}

Gunter, Marc ^{[22
]}

Masala, Giovanna ^{[23
]}

Sieri, Sabina ^{[24
]}

Tumino, Rosario ^{[25
]}

Panico, Salvatore ^{[26
]}

Boer, Jolanda M. A. ^{[27
]}

Verschuren, W. M. Monique ^{[1
,27
]}

Salamanca-Fernandez, Elena ^{[7
,28
]}

Arriola, Larraitz ^{[7
,29
]}

Moreno-Iribas, Conchi ^{[30
,31
]}

Engstrom, Gunnar ^{[32
]}

Melander, Olle ^{[32
]}

Nordendahl, Maria ^{[33
]}

Wennberg, Patrik ^{[33
]}

Key, Timothy J. ^{[34
]}

Colorado-Yohar, Sandra ^{[35
,36
]}

Matullo, Giuseppe ^{[37
,38
]}

Overvad, Kim ^{[39
]}

Clavel-Chapelon, Francoise ^{[40
]}

Boeing, Heiner ^{[41
]}

Quiros, J. Ramon ^{[42
]}

di Angelantonio, Emanuele ^{[4
]}

Langenberg, Claudia ^{[43
]}

Sweeting, Michael J. ^{[4
]}

Riboli, Elio ^{[44
]}

Wareham, Nicholas J. ^{[43
]}

Danesh, John ^{[43
]}

Butterworth, Adam ^{[5
,45
]}

机构：

[1] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, Huispostnr STR 6-131,POB 85500, NL-3508 GA Utrecht, Netherlands

[2] Netherlands Heart Inst, Utrecht, Netherlands

[3] Univ Oxford, George Inst Global Hlth, Oxford, England

[4] Univ Cambridge, MRK Biostat Unit, Cambridge, England

[5] Univ Cambridge, Dept Publ Hlth & Primary Care, Cambridge, England

[6] Murcia Univ, Dept Epidemiol, IMIB Arraxaca, Reg Hlth Author, Murcia, Spain

[7] CIBERESP, Dept Epidemiol, Madrid, Spain

[8] Univ Cambridge, Dept Publ Hlth & Primary Care, Cardiovasc Epidemiol Unit, Cambridge, England

[9] Homerton Coll, Cambridge, England

[10] German Canc Res Ctr, Div Clin Epidemiol & Aging Res, Heidelberg, Germany

[11] German Canc Res Ctr, German Canc Consortium DKTK, Heidelberg, Germany

[12] Univ Tromso, Arctic Univ Norway, Fac Hlth Sci, Dept Community Med, Tromso, Norway

[13] Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden

[14] Folkhalsan Res Ctr, Genet Epidemiol Grp, Helsinki, Finland

[15] Inst Populat Based Canc Res, Dept Res, Canc Registry Norway, Oslo, Norway

[16] Danish Canc Soc Res Ctr, Dept Diet Genes & Environm, Copenhagen, Denmark

[17] German Canc Res Ctr, Div Canc Epidemiol, Heidelberg, Germany

[18] Hellen Healt Fdn, Pulm Med Dept 2, Athens, Greece

[19] Natl & Kapodistrian Univ Athens, Collaborating Ctr Nutr & Hlth, Dept Hyg Epidemiol & Med Stat, Unit Nutr Epidemiol & Nutr Publ Hlth,Sch Med,WHO, Athens, Greece

[20] Natl & Kapodistrian Univ Athens, ATTIKON Univ Hosp, Sch Med, Pulm Med Dept 2, Haidari, Greece

[21] Univ Milan, Dept Clin Sci & Community Hlth, Milan, Italy

[22] Int Agcy Res Canc, Lyon, France

[23] ISPO, Canc Risk Factors & Life Style Epidemiol Unit, Canc Res & Prevent Inst, Florence, Italy

[24] Fdn IRCCS Inst Nazl Tumori, Epidemiol & Prevent Unit, Milan, Italy

[25] ASP Ragusa, Canc Registry & Histopathol Dept, Civ MP Arezzo Hosp, Ragusa, Italy

[26] Univ Naples Federico II, Dipartimento Med Clin & Chirurgia, Naples, Italy

[27] Natl Inst Publ Hlth & Environm RIVM, Ctr Nutr Prevent & Hlth Serv, Bilthoven, Netherlands

[28] Univ Granada, Hosp Univ Granada, Inst Invest Biosanitaria Ibs, Escuela Andaluza Salud Publ, Granada, Spain

[29] Basque Govt, Publ Hlth Div Gipuzkoa, Inst BIOdonostia, Donostia San Sebastian, Spain

[30] Navarre Inst Hlth Res, Inst Salud Publ Navarra, IdiSNA, Pamplona, Spain

[31] REDISSEC, Red Serv Salud Orientados Enfermedades Cron, Pamplona, Spain

[32] Lund Univ, Dept Clin Sci, Malmo, Sweden

[33] Umeg Univ, Dept Publ Hlth & Clin Med, Family Med, Umeg, Sweden

[34] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford, England

[35] Murcia Reg Hlth Council, Dept Epidemiol, IMIB Arrixaca, Murcia, Spain

[36] Univ Antioquia, Natl Fac Publ Hlth, Res Grp Demog & Hlth, Medellin, Colombia

[37] Univ Torino, Dept Med Sci, Turin, Italy

[38] Italian Inst Genom Med IIGM HuGeF, Dept Med Sci, Turin, Italy

[39] Aarhus Univ, Dept Publ Hlth, Sect Epidemiol, Aarhus, Denmark

[40] Inst Gustave Roussy, Ctr Res Epidemiol & Populat Hlth CESP, Nutr Hormones & Womens Hlth Team, U1018,INSERM, Villejuif, France

[41] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, Potsdam, Germany

[42] Publ Hlth Directorate, Asturias, Spain

[43] Univ Cambridge, MRC Epidemiol Unit, Sch Clin Med, Cambridge, England

[44] Imperial Coll London, Sch Publ Hlth, Dept Epidemiol & Biostat, London, England

[45] London Sch Hyg & Trop Med, Dept Med Stat, London, England

来源：

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY | 2019年 / 48卷 / 04期

基金：

欧洲研究理事会; 英国医学研究理事会;

关键词：

Menopause; coronary disease; ageing; Epidemiology; women; risk factors; LIFE-STYLE FACTORS; CARDIOVASCULAR-DISEASE; INTRAINDIVIDUAL CHANGES; BLOOD-PRESSURE; SERUM-LIPIDS; BODY-WEIGHT; AGE; CANCER; OOPHORECTOMY; WOMEN;

D O I：

10.1093/ije/dyz016

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Earlier age at menopause has been associated with increased risk of coronary heart disease (CHD), but the shape of association and role of established cardiovascular risk factors remain unclear. Therefore, we examined the associations between menopausal characteristics and CHD risk; the shape of the association between age at menopause and CHD risk; and the extent to which these associations are explained by established cardiovascular risk factors. Methods We used data from EPIC-CVD, a case-cohort study, which includes data from 23 centres from 10 European countries. We included only women, of whom 10880 comprise the randomly selected sub-cohort, supplemented with 4522 cases outside the sub-cohort. We conducted Prentice-weighted Cox proportional hazards regressions with age as the underlying time scale, stratified by country and adjusted for relevant confounders. Results After confounder and intermediate adjustment, post-menopausal women were not at higher CHD risk compared with pre-menopausal women. Among post-menopausal women, earlier menopause was linearly associated with higher CHD risk [HRconfounder and intermediate adjusted per-year decrease=1.02, 95% confidence interval (CI)=1.01-1.03, p=0.001]. Women with a surgical menopause were at higher risk of CHD compared with those with natural menopause (HRconfounder-adjusted=1.25, 95% CI=1.10-1.42, p<0.001), but this attenuated after additional adjustment for age at menopause and intermediates (HR=1.12, 95% CI=0.96-1.29, p=0.15). A proportion of the association was explained by cardiovascular risk factors. Conclusions Earlier and surgical menopause were associated with higher CHD risk. These associations could partially be explained by differences in conventional cardiovascular risk factors. These women might benefit from close monitoring of cardiovascular risk factors and disease.

引用

页码：1275 / 1285

页数：11

共 41 条

[1]

[Anonymous], 1987, Multiple Imputationsfor Nonresponse in Surveys

[2] Postmenopausal status and early menopause as independent risk factors for cardiovascular disease: a meta-analysis [J].

Atsma, F ;

Bartelink, MLEL ;

Grobbee, DE ;

van der Schouw, YT .

MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, 2006, 13 (02) :265-279

[3] THE MODERATOR MEDIATOR VARIABLE DISTINCTION IN SOCIAL PSYCHOLOGICAL-RESEARCH - CONCEPTUAL, STRATEGIC, AND STATISTICAL CONSIDERATIONS [J].

BARON, RM ;

KENNY, DA .

JOURNAL OF PERSONALITY AND SOCIAL PSYCHOLOGY, 1986, 51 (06) :1173-1182

[4] Differential effects of reproductive factors on the risk of pre- and postmenopausal breast cancer. Results from a large cohort of French women [J].

Clavel-Chapelon, F .

BRITISH JOURNAL OF CANCER, 2002, 86 (05) :723-727

[5] A validation study on status and age of natural menopause reported in the E3N cohort [J].

Clavel-Chapelon, F ;

Dormoy-Mortier, N .

MATURITAS, 1998, 29 (02) :99-103

[6] REPRODUCIBILITY AND VALIDITY OF SELF-REPORTED MENOPAUSAL STATUS IN A PROSPECTIVE COHORT STUDY [J].

COLDITZ, GA ;

STAMPFER, MJ ;

WILLETT, WC ;

STASON, WB ;

ROSNER, B ;

HENNEKENS, CH ;

SPEIZER, FE .

AMERICAN JOURNAL OF EPIDEMIOLOGY, 1987, 126 (02) :319-325

[7] MENOPAUSE AND THE RISK OF CORONARY HEART-DISEASE IN WOMEN [J].

COLDITZ, GA ;

WILLETT, WC ;

STAMPFER, MJ ;

ROSNER, B ;

SPEIZER, FE ;

HENNEKENS, CH .

NEW ENGLAND JOURNAL OF MEDICINE, 1987, 316 (18) :1105-1110

[8] EPIC-Heart:: The cardiovascular component of a prospective study of nutritional, lifestyle and biological factors in 520,000 middle-aged participants from 10 European countries [J].

Danesh, John ;

Saracci, Rodolfo ;

Berglund, Goran ;

Feskens, Edith ;

Overvad, Kim ;

Panico, Salvatore ;

Thompson, Simon ;

Fournier, Agnes ;

Clavel-Chapelon, Francoise ;

Canonico, Marianne ;

Kaaks, Rudolf ;

Linseisen, Jakob ;

Boeing, Heiner ;

Pischon, Tobias ;

Weikert, Cornelia ;

Olsen, Anja ;

Tjonneland, Anne ;

Johnsen, Soren Paaske ;

Jensen, Majken Karoline ;

Quiros, Jose R. ;

Gonzalez Svatetz, Carlos Alberto ;

Sanchez Perez, Maria-Jose ;

Larranaga, Nerea ;

Navarro Sanchez, Carmen ;

Moreno Iribas, Concepcion ;

Bingham, Sheila ;

Khaw, Kay-Tee ;

Wareham, Nick ;

Key, Timothy ;

Roddam, Andrew ;

Trichopoulou, Antonia ;

Benetou, Vassiliki ;

Trichopoulos, Dimitrios ;

Masala, Giovanna ;

Sieri, Sabina ;

Tumino, Rosario ;

Sacerdote, Carlotta ;

Mattiello, Amalia ;

Verschuren, W. M. Monique ;

Bueno-de-Mesquita, H. Bas ;

Grobbee, Diederick E. ;

van der Schouw, Yvonne T. ;

Melander, Olle ;

Hallmans, Goran ;

Wennberg, Patrik ;

Lund, Eiliv ;

Kumle, Merethe ;

Skeie, Guri ;

Ferrari, Pietro ;

Slimani, Nadia .

EUROPEAN JOURNAL OF EPIDEMIOLOGY, 2007, 22 (02) :129-141

[9] Unraveling the associations of age and menopause with cardiovascular risk factors in a large population-based study [J].

de Kat, A. C. ;

Dam, V. ;

Onland-Moret, N. C. ;

Eijkemans, M. J. C. ;

Broekmans, F. J. M. ;

van der Schouw, Y. T. .

BMC MEDICINE, 2017, 15

[10]

Do KA, 2000, AM J EPIDEMIOL, V151, P584, DOI 10.1093/oxfordjournals.aje.a010246

← 1 2 3 4 5 →