A longitudinal analysis on the effect of hormone use on allostatic load in perimenopausal women

Pamela Lamisi Alebna , Joaquin Ignacio Armendano , Nasim Maleki
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Abstract

Background

Allostatic load (AL), a measure of physiologic dysregulation across multiple systems, has been shown to increase as women age and go through menopause. While hormone use has been shown to help with the relief of menopausal symptoms, it is not clear whether the use of hormone replacement therapy and hormonal contraceptives in the perimenopausal period has an impact on alleviating allostatic load in aging women.

Methods

We conducted a target trial emulation to estimate the on-treatment (i.e., per-protocol) effect of hormone replacement therapy or hormonal contraceptives use on AL score evolution over time. We included in our analysis 2,199 women from the SWAN cohort that were followed-up between 1996 and 2005. To estimate the effect of the continuous use of hormone replacement therapy or hormonal contraceptives on AL score evolution over the follow-up period we used marginal structural models estimated using inverse probability weighting.

Results

The mean AL score at baseline was 2.45 ± 1.85 (Mean ± SD). The AL score remained relatively stable in women that never used hormone replacement therapy or hormonal contraceptives, with an average increase of 0.014 ± 0.011 (Mean ± SE) per year, whereas in women that used hormone replacement therapy or hormonal contraceptives continuously, the AL score increased, on average 0.087 ± 0.014 (Mean ± SE) per year. We did not find conclusive evidence to support that continuous use of hormone replacement therapy or hormonal contraceptives modifies the AL score trajectory (mean difference between trends = 0.073; CI95%: -0.027, 0.173; P = 0.1538).

Conclusion

Continuous use of hormone replacement therapy or hormonal contraceptives during the menopause transition period was not associated with increased allostatic load. The findings suggest continuous use of hormone therapy as a treatment for perimenopausal symptoms in aging women doesn't confer a risk for increased allostatic load.
激素使用对围绝经期妇女适应负荷影响的纵向分析
适应负荷(AL)是衡量多系统生理失调的一种指标,随着女性年龄的增长和绝经期的增加而增加。虽然激素的使用已被证明有助于缓解更年期症状,但在围绝经期使用激素替代疗法和激素避孕药是否对减轻老年妇女的适应负荷有影响尚不清楚。方法我们进行了一项目标试验模拟,以估计激素替代疗法或激素避孕药的使用对AL评分随时间演变的影响。我们在分析中纳入了1996年至2005年间随访的来自SWAN队列的2199名女性。为了估计持续使用激素替代疗法或激素避孕药对随访期间AL评分演变的影响,我们使用了使用逆概率加权估计的边际结构模型。结果基线时平均AL评分为2.45±1.85 (mean±SD)。未使用激素替代治疗或激素避孕药的女性AL评分相对稳定,平均每年增加0.014±0.011 (Mean±SE),而持续使用激素替代治疗或激素避孕药的女性AL评分增加,平均每年增加0.087±0.014 (Mean±SE)。我们没有发现确凿的证据支持持续使用激素替代疗法或激素避孕药会改变AL评分轨迹(趋势间的平均差异= 0.073;Ci95%: -0.027, 0.173;P = 0.1538)。结论在绝经过渡期持续使用激素替代疗法或激素避孕药与适应负荷增加无关。研究结果表明,持续使用激素治疗作为老年妇女围绝经期症状的治疗并不会增加适应负荷的风险。
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来源期刊
Aging and health research
Aging and health research Clinical Neurology, Public Health and Health Policy, Geriatrics and Gerontology
CiteScore
0.60
自引率
0.00%
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0
审稿时长
12 weeks
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