Maturitas最新文献

{"title":"Does Rose angina in midlife women matter? Further evidence from the Royal College of General Practitioners' Oral Contraception Study","authors":"Katarzyna Galka ,&nbsp;David J. McLernon ,&nbsp;Philip C. Hannaford ,&nbsp;Lisa Iversen","doi":"10.1016/j.maturitas.2024.108189","DOIUrl":"10.1016/j.maturitas.2024.108189","url":null,"abstract":"<div><h3>Background and aims</h3><div>Globally, ischaemic heart disease (IHD) is a leading cause of death among women; however, disparities remain in the diagnosis and treatment of IHD between females and males. There is limited evidence about mortality risks among women with symptoms of IHD who remain undiagnosed. We re-examined the mortality risks in midlife women who completed the Rose Angina Questionnaire, among a subset of the Royal College of General Practitioners' Oral Contraception Study cohort.</div></div><div><h3>Methods</h3><div>8694 women in the cohort completed the Rose Angina Questionnaire, enquiring about symptoms of exertional chest pain, likely angina, and prior myocardial infarction. The women were followed for vital status and cause of death information until 30 June 2022. The relationship between different types of Rose angina and all-cause and cause-specific mortality was examined using Kaplan-Meier survival curves, and unadjusted and adjusted Cox regression.</div></div><div><h3>Results</h3><div>After 27 years, 3263 (37.5 %) women had died. Compared with women who did not report symptoms, women with Rose angina had an increased risk of all-cause and IHD death. Women without a prior IHD diagnosis and grade II Rose angina at survey had the highest all-cause (adjusted hazard ratio [aHR] 2.14, 95 % confidence interval [CI] 1.55 to 2.97) and IHD-specific (aHR 3.18, 95 % CI 1.64 to 6.17) mortality risks.</div></div><div><h3>Conclusions</h3><div>Women reporting Rose chest pain had a higher risk of all-cause and IHD death, even in the absence of a prior IHD history. These findings highlight the importance of identifying symptomatic women in midlife, so their IHD risk can be managed appropriately by their healthcare providers.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"194 ","pages":"Article 108189"},"PeriodicalIF":3.9,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of muscle mass relative to weight/sitting height2 improves the association with physical performance","authors":"Jianan Shi ,&nbsp;Xiao Gao ,&nbsp;Shuyuan Si ,&nbsp;Lingping Luo ,&nbsp;Si Chen ,&nbsp;Ming Li","doi":"10.1016/j.maturitas.2024.108192","DOIUrl":"10.1016/j.maturitas.2024.108192","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare relationships of appendicular skeletal muscle mass (ASM) with the function of the upper and lower extremities, after the former has been adjusted by five body size variables: height²; weight; body mass index (BMI); sitting height²; and weight/sitting height².</div></div><div><h3>Study design</h3><div>A cross-sectional study of data derived from the baseline phase of the Physical Activity and Health in Older Women Study.</div></div><div><h3>Main outcome measures</h3><div>ASM was measured by bioelectrical impedance analysis. Grip strength and the time spent on the 5-times chair stand test (5-CST) were the evaluation indexes of upper and lower extremity function respectively. Standardized grip strength and log-transformed 5-CST were used as dependent variables, and standardized ASM adjusted by the five body size variables were used as independent variables. Multiple linear regression models then assessed the relationships of muscle mass with grip strength and 5-CST.</div></div><div><h3>Results</h3><div>1103 community-dwelling women aged 60–70 years were included in this study. After adjustment for covariates, ASM adjusted by height² or sitting height² was positively associated with grip strength (β = 0.140, 0.164 respectively, all <em>P</em> values &lt;0.001), and only ASM adjusted by sitting height² was positively associated with the time spent on the 5-CST (β = 0.129, <em>P</em> &lt; 0.001). Weight-adjusted ASM was associated only with the time spent on the 5-CST (β = −0.158, <em>P</em> &lt; 0.001) and BMI-adjusted ASM was associated only with grip strength (β = 0.190, <em>P</em> &lt; 0.001). ASM adjusted by weight/sitting height² was positively associated with grip strength (β = 0.140, <em>P</em> &lt; 0.001) and negatively associated with the time spent on the 5-CST (β = −0.076, <em>P</em> = 0.012).</div></div><div><h3>Conclusions</h3><div>Compared to ASM adjusted by the other four body size variables, ASM adjusted by weight/sitting height² had better associations with upper and lower extremity function, which provides new perspectives for improving muscle mass and predicting adverse outcomes.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"194 ","pages":"Article 108192"},"PeriodicalIF":3.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, content validation and feasibility of a decision aid tool for the treatment of women with menopausal symptoms","authors":"Petra Stute ,&nbsp;Małgorzata Bińkowska ,&nbsp;Paula Briggs ,&nbsp;Santiago Palacios ,&nbsp;Linda Abetz-Webb ,&nbsp;Vivienne Law ,&nbsp;Renata Zablotna-Pociupany ,&nbsp;Mitra Boolell","doi":"10.1016/j.maturitas.2025.108195","DOIUrl":"10.1016/j.maturitas.2025.108195","url":null,"abstract":"<div><h3>Introduction</h3><div>Despite research supporting menopause hormonal therapy for menopausal women, its use continues to decline in most European countries and the United States. Experts highlighted the need for global assessment tools to assist clinicians in evaluating treatment for symptomatic menopausal women, which led to the development of the Menopause Treatment Tool, with separate versions for women and healthcare professionals. Both versions of the tool focus on menopausal symptoms, risk levels and suggested actions; the women's tool is administered prior to the consultation, while the clinician tool is administered by the clinician during the clinical consultation.</div></div><div><h3>Objective</h3><div>To assess content validity and feasibility of the Menopause Treatment Tool (for women and for clinicians) in clinical practice.</div></div><div><h3>Methods</h3><div>This non-interventional study collected post-consultation feedback through questionnaires and interviews with clinicians and questionnaires with menopausal women in the United Kingdom, Germany, Italy, Poland, Spain, Switzerland, and the US. Qualitative and descriptive analyses were conducted.</div></div><div><h3>Results</h3><div>Eight primary care physicians (UK, US only) and 41 gynaecologists (all countries, except the UK), with an average of 13 years of practice, participated. Menopausal women (<em>n</em> = 172) were aged between 45 and 61 years (mean 52 years).</div><div>Based on feedback questionnaires from 160 clinicians and 156 menopausal women, most (&gt;85 %) clinicians and women reported both tools to be convenient and valuable for discussing symptoms and treatment options. Most clinicians (&gt;55 %) and women (&gt;70 %) reported improved interactions and confidence in treatment decisions. Several clinicians preferred making these tools electronically available for better integration with patient records.</div></div><div><h3>Conclusions</h3><div>This study confirmed the Menopause Treatment Tool's content validity and feasibility for use in clinical practice. The Menopause Treatment Tool enhanced discussions between clinicians and women about menopause symptoms and treatment benefits/risks, boosting confidence in treatment decisions.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"194 ","pages":"Article 108195"},"PeriodicalIF":3.9,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of sarcopenia: A red flag for cognitive decline in postmenopause?","authors":"María S. Vallejo ,&nbsp;Juan E. Blümel ,&nbsp;Peter Chedraui ,&nbsp;Konstantinos Tserotas ,&nbsp;Carlos Salinas ,&nbsp;Marcio A. Rodrigues ,&nbsp;Doris Rodríguez-Vidal ,&nbsp;Claudia Rey ,&nbsp;Eliana Ojeda ,&nbsp;Mónica Ñañez ,&nbsp;Álvaro Monterrosa-Castro ,&nbsp;Gustavo Gómez-Tabares ,&nbsp;María T. Espinoza ,&nbsp;Carlos Escalante ,&nbsp;Alejandra Elizalde ,&nbsp;Maribel Dextre ,&nbsp;Andrés Calle ,&nbsp;Sócrates Aedo","doi":"10.1016/j.maturitas.2025.108193","DOIUrl":"10.1016/j.maturitas.2025.108193","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if the SARC-F tool, used to screen for sarcopenia risk, can also predict mild cognitive impairment (MCI) diagnosed with the Montreal Cognitive Assessment (MoCA) tool.</div></div><div><h3>Methods</h3><div>This is a sub-analysis of data from a cross-sectional study carried out in postmenopausal women from Latin America (nine countries) in which sociodemographic, clinical, and anthropometric data were collected, and the SARC-F and MoCA tools administered. From the original sample of 1185 women, analysis was performed only among the 772 with natural menopause.</div></div><div><h3>Results</h3><div>Overall, mean age, body mass index and years of education were 56.9 years, 26.8 kg/m² and 13.6 years, respectively. Women with MCI displayed a higher body mass index, had more children, experienced more severe menopausal symptoms, and were more frequently homemakers and physically inactive. The prevalence of MCI increased from 12.9 % in women with no sarcopenia risk (SARC-F &lt; 4 points) to 35.3 % in those at risk (OR 3.70; 95 % CI 2.36–5.80). According to binary logistic regression analysis, sarcopenia risk (total SARC-F score ≥ 4) was associated with MCI (OR: 2.44; 95 % CI 1.50–3.95). Aside from the risk of sarcopenia, being a homemaker (OR 1.97; 95 % CI 1.25–3.10) was also associated with an increased likelihood of MCI. Protective factors included ever use of menopausal hormone therapy (OR 0.26; 95 % CI 0.13–0.54) and having higher educational attainment (OR 0.28; 95 % CI 95 % 0.16–0.47). The SARC-F displayed a sensitivity of 84 % and a specificity of 39 % at diagnosing MCI.</div></div><div><h3>Conclusion</h3><div>This study suggests that the SARC-F questionnaire, used to assess sarcopenia risk, could also predict the presence of MCI in postmenopausal women. There is a need for more research to support our preliminary findings.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"194 ","pages":"Article 108193"},"PeriodicalIF":3.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated neutrophil-percentage-to-albumin ratio predicts increased all-cause and cardiovascular mortality in hypertensive patients: Evidence from NHANES 1999–2018","authors":"Yan Yang ,&nbsp;Renzhong Ding ,&nbsp;TingTing Li ,&nbsp;Ruihao Li,&nbsp;Yi Song,&nbsp;Ye Yuan,&nbsp;Xue Bai,&nbsp;Yijie Hu","doi":"10.1016/j.maturitas.2024.108169","DOIUrl":"10.1016/j.maturitas.2024.108169","url":null,"abstract":"<div><h3>Background</h3><div>This study investigates the association between the neutrophil-percentage-to-albumin ratio (NPAR) and all-cause mortality in patients with hypertension, and its relationship with cardiovascular mortality.</div></div><div><h3>Methods</h3><div>This study examined data from 18,469 adults with hypertension in the National Health and Nutrition Examination Survey (1999–2018) and the mortality data from the National Death Index. The link between NPAR and mortality risk was visualized using restricted cubic splines. The optimal NPAR cut-off value for the prediction of survival outcomes was identified via maximally selected rank statistics. We employed weighted multivariate Cox regression and subgroup analyses to evaluate the relationship between NPAR and risk of all-cause and cardiovascular mortality. We assessed NPAR's predictive accuracy for survival outcomes using time-related receiver operating characteristic analysis.</div></div><div><h3>Results</h3><div>During a median follow-up of 105 months, 31.8 % of 18,469 participants died, with 8.9 % from cardiovascular causes. Restricted cubic splines analysis showed a positive link between NPAR and both all-cause and cardiovascular mortality. Cox models indicated that higher NPAR (&gt;1602.08) significantly raised risks of all-cause (HR 1.80, 95 % CI 1.54–2.12, <em>p</em> &lt; 0.0001) and cardiovascular mortality (HR 1.54, 95 % CI 1.24–1.91, p &lt; 0.0001). The stability of results was confirmed through stratified and interaction analyses. The area under the curve for 3-, 5-, and 10-year survival were 0.67, 0.65, and 0.63 for all-cause mortality and 0.61, 0.62, and 0.63 for cardiovascular mortality.</div></div><div><h3>Conclusions</h3><div>Elevated NPAR independently raises the risk of all-cause and cardiovascular mortality in hypertensive patients, indicating its potential in the clinic as a practical tool for predicting long-term mortality risks and influencing treatment strategies.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"192 ","pages":"Article 108169"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142815434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing andropause: Challenges and strategies for healthy aging in men","authors":"George A. Kanakis ,&nbsp;Dimitrios G. Goulis","doi":"10.1016/j.maturitas.2024.108041","DOIUrl":"10.1016/j.maturitas.2024.108041","url":null,"abstract":"","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"192 ","pages":"Article 108041"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141394904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of digital phenotyping based on continuous glucose monitoring to support personalized lifestyle medicine in type 2 diabetes","authors":"Willem J. van den Brink ,&nbsp;Tim J. van den Broek ,&nbsp;Suzan Wopereis ,&nbsp;Sonia Difrancesco ,&nbsp;Frans A.L. van der Horst ,&nbsp;Iris M. de Hoogh","doi":"10.1016/j.maturitas.2024.108188","DOIUrl":"10.1016/j.maturitas.2024.108188","url":null,"abstract":"<div><h3>Objectives</h3><div>Type 2 diabetes is a highly prevalent age-related chronic condition, with complex and heterogeneous pathogenesis. A 5-point oral glucose tolerance test can identify type 2 diabetes subtypes or “diabetypes” based on the degree of insulin resistance in muscle and/or liver, and beta-cell dysfunction. Due to its costly and invasive nature, the oral glucose tolerance test is not scalable. Presuming that differences in glucose and insulin dynamics manifest in continuous glucose monitoring profiles, we explore the potential of continuous glucose metrics to replace the oral glucose tolerance test for diabetyping.</div></div><div><h3>Study design</h3><div>In a prospective intervention study, 41 people with type 2 diabetes on lifestyle and/or metformin treatment wore a continuous glucose monitor during 3 control periods of 4 days. During each control period, participants underwent a 5-point oral glucose tolerance test after an overnight fast.</div></div><div><h3>Main outcome measures</h3><div>Continuous glucose monitoring data from the control periods, excluding the day of the oral glucose tolerance test, was retrospectively analyzed for associations with diabetypes, as well as Spearman correlations between bootstrapped continuous glucose features, including physiology-based and other time-series features, and oral glucose tolerance metrics.</div></div><div><h3>Results</h3><div>Significant associations were observed between continuous glucose metrics (e.g., low and high blood glucose index, eA1c, and glucose excursions) and oral glucose tolerance metrics (e.g., 2-h glucose, disposition index, insulinogenic index). Furthermore, data-driven metrics (e.g., maximum shift, lumpiness) showed more selective correlations, indicating that data-driven metrics may contain additional information associated with oral glucose tolerance metrics.</div></div><div><h3>Conclusions</h3><div>These results indicate the potential of continuous glucose monitoring to replace the oral glucose tolerance test for diabetyping, driving proactive and personalized (lifestyle) treatment.</div></div><div><h3>Netherlands trial register</h3><div>NL7848</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"194 ","pages":"Article 108188"},"PeriodicalIF":3.9,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between handgrip strength and metabolic syndrome: A large prospective Chinese cohort study","authors":"Hongmei Wu ,&nbsp;Di Wang ,&nbsp;Xuena Wang ,&nbsp;Yeqing Gu ,&nbsp;Ge Meng ,&nbsp;Qing Zhang ,&nbsp;Li Liu ,&nbsp;Xing Wang ,&nbsp;Shaomei Sun ,&nbsp;Qiyu Jia ,&nbsp;Kun Song ,&nbsp;Jian Huang ,&nbsp;Junsheng Huo ,&nbsp;Bing Zhang ,&nbsp;Gangqiang Ding ,&nbsp;Hong Chang ,&nbsp;Kaijun Niu","doi":"10.1016/j.maturitas.2024.108157","DOIUrl":"10.1016/j.maturitas.2024.108157","url":null,"abstract":"<div><h3>Objectives</h3><div>Many studies have explored the association between handgrip strength and metabolic syndrome; however, the findings are inconsistent due to the different types of indicators used to assess handgrip strength (absolute vs. relative handgrip strength). This prospective cohort study aimed to simultaneously investigate the associations of both absolute and relative handgrip strength with metabolic syndrome, and to compare the predictive abilities of these two measures among Chinese adults.</div></div><div><h3>Methods</h3><div>Cox proportional hazards regression models were used to analyze 15,820 participants (49.7 % men) living in Tianjin, China. Handgrip strength was measured using a handheld dynamometer. Relative handgrip strength was normalized to body weight (kg).</div></div><div><h3>Results</h3><div>During the 6-year follow-up, there were 3385 incident cases of metabolic syndrome. The fully adjusted hazards ratios (95 % confidence interval) of the incidence of metabolic syndrome for increasing quartiles of relative handgrip strength were: 1.000 (reference), 0.871(0.780, 0.973), 0.675(0.602, 0.757), 0.454(0.401, 0.513) in men and 1.000 (reference), 0.830(0.714, 0.966), 0.561(0.471, 0.668), and 0.369(0.301, 0.452) in women (both <em>P</em> for trend &lt;0.0001). The optimal cut-off of relative handgrip strength to predict incident metabolic syndrome was 0.563 kg/kg in men (sensitivity = 64.3 %, specificity = 55.6 %) and 0.436 kg/kg in women (sensitivity = 57.0 %, specificity = 69.3 %).</div></div><div><h3>Conclusions</h3><div>This large cohort study showed that higher relative handgrip strength, but not absolute handgrip strength, was associated with a lower risk of metabolic syndrome. Although handgrip strength may not be highly sensitive in screening for metabolic syndrome, it remains a valuable predictive tool due to its convenience, ease of measurement, and cost-effectiveness.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"192 ","pages":"Article 108157"},"PeriodicalIF":3.9,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic kidney disease and menopausal health: An EMAS clinical guide","authors":"E. Cansu Cevik ,&nbsp;C. Tamer Erel ,&nbsp;Ipek Betul Ozcivit Erkan ,&nbsp;Pantelis Sarafidis ,&nbsp;Eleni Armeni ,&nbsp;Ivan Fistonić ,&nbsp;Timothy Hillard ,&nbsp;Angelica Lindén Hirschberg ,&nbsp;Blazej Meczekalski ,&nbsp;Nicolás Mendoza ,&nbsp;Alfred O. Mueck ,&nbsp;Tommaso Simoncini ,&nbsp;Petra Stute ,&nbsp;Dorenda van Dijken ,&nbsp;Margaret Rees ,&nbsp;Irene Lambrinoudaki","doi":"10.1016/j.maturitas.2024.108145","DOIUrl":"10.1016/j.maturitas.2024.108145","url":null,"abstract":"<div><div>Kidney diseases are related to the aging process. Ovarian senescence and the loss of estrogen's renoprotective effects are directly associated with a decline in renal function and indirectly with an accumulation of cardiometabolic risk factors. The latter can predispose to the development of chronic kidney disease (CKD). Conversely, CKD diagnosed during reproductive life adversely affects ovarian function.</div></div><div><h3>Aim</h3><div>To set out an individualized approach to menopause management in women with CKD.</div></div><div><h3>Materials and methods</h3><div>Literature review and consensus of expert opinion.</div></div><div><h3>Summary recommendations</h3><div>Menopause hormone therapy can be given to women with CKD. The regimen should be selected on the basis of patient preference and the individual's cardiovascular risk. The dose of hormonal and non-hormonal preparations should be adjusted in accordance with the patient's creatinine clearance. The management of a postmenopausal woman with CKD should focus on lifestyle advice as well as regular monitoring of the main cardiovascular risk factors and evaluation of bone mineral density. Tailored multidisciplinary advice should be given to women with comorbidities such as diabetes, dyslipidemia, and hypertension. Management of osteoporosis should be based on the severity of the CKD.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"192 ","pages":"Article 108145"},"PeriodicalIF":3.9,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic inequality in the multimorbidity trajectories of middle-aged and older adults in China: A prospective cohort study","authors":"Chuanbo An ,&nbsp;Hui Chen ,&nbsp;Yangyang Cheng ,&nbsp;Zifan Zhang ,&nbsp;Changzheng Yuan ,&nbsp;Xiaolin Xu","doi":"10.1016/j.maturitas.2024.108160","DOIUrl":"10.1016/j.maturitas.2024.108160","url":null,"abstract":"<div><h3>Objective</h3><div>The prevalence of multimorbidity is socially patterned, but little is known about how socioeconomic inequality might affect the long-term progression of multimorbidity. This study aimed to identify multimorbidity trajectories and to examine their association with socioeconomic status (SES) among middle-aged and older Chinese adults.</div></div><div><h3>Methods</h3><div>A total of 3837 middle-aged and older participants were included from the dynamic cohort of the China Health and Retirement Longitudinal Study, 2011–2018. Multimorbidity trajectories were assessed using the Chinese Multimorbidity-Weighted Index (CMWI), which covers 14 chronic conditions. Group-based trajectory modeling was used to identify multimorbidity developmental trajectories. Education, working status, and total household income were used to construct SES scores. The associations between SES and CMWI trajectories were estimated using multinomial logistic regression models adjusting for sociodemographic and lifestyle factors.</div></div><div><h3>Results</h3><div>Four distinct CMWI trajectories were identified: ‘no multimorbidity’ (16.8 %), ‘new-onset multimorbidity’ (48.7 %), ‘slowly increasing multimorbidity’ (24.3 %), and ‘rapidly increasing multimorbidity’ (10.2 %). Lower SES was associated with higher odds of experiencing the ‘rapidly increasing’ trajectory (P _trend &lt; 0.01); for example, compared with the ‘no multimorbidity’ group, participants with low SES had a 96 % (OR, 1.96; 95 % CI, 1.29 to 2.98) increased odds of belonging to the ‘rapidly increasing’ group.</div></div><div><h3>Conclusion</h3><div>Socioeconomic inequalities were observed in the CMWI trajectories of multimorbidity in middle-aged and older Chinese adults. The findings suggest effective strategies for preventing and controlling multimorbidity should be made from a long-term perspective, especially for those of lower SES.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"192 ","pages":"Article 108160"},"PeriodicalIF":3.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142746027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}