绝经类型和绝经年龄对老年妇女虚弱可能性的相互作用和联合影响以及绝经年龄的中介作用：来自NHANES 1999-2018的基于人群的分析

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas Pub Date : 2025-07-29 DOI:10.1016/j.maturitas.2025.108680

Huijie Guo , Yilu Ye , Zhihua Liu , Yunfei Gao , Guoheng Liu , Jianguo Zhao , Ying Yang , Qun He

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引用次数: 0

摘要

目的探讨老年妇女手术绝经、绝经年龄和虚弱之间的关系。此外，我们研究了绝经年龄是否介导了手术绝经和虚弱之间的潜在关联，以及手术绝经和绝经年龄对虚弱的相互作用或联合作用的程度。方法分析1999-2018年全国健康与营养调查中7462名年龄≥60岁的女性。虚弱是用49项虚弱指数来衡量的，如果该指数的得分超过0.21，就被诊断为虚弱。使用标准化的生殖健康问卷收集绝经期数据。采用调查加权logistic回归模型评估手术绝经、绝经年龄和虚弱之间的关系。我们还在乘法和加性尺度上进行了中介分析和相互作用分析。结果7462例女性中，2687例（32.4%）存在虚弱。有手术停经史的女性与自然停经的女性相比，衰弱的优势比（OR）为1.44 （95% CI: 1.25-1.66）。绝经年龄介导26.4%的手术绝经和虚弱之间的总关联。绝经类型和绝经年龄对衰弱的影响未观察到显著的乘法或加性相互作用(加性：相互作用导致的相对超额风险= - 0.01,95% CI: - 0.32-0.31；乘数，OR = 0.94, 95% CI: 0.75-1.19)。与自然绝经和不提前绝经的人相比，手术绝经和提前绝经的人的关节ORs为1.59 （95% CI: 1.40-1.81）。结论在绝经后妇女中，手术绝经比自然绝经更容易出现身体虚弱。绝经年龄介导了超过26%的相关性。

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Interacting and joint effects of type of menopause and age at menopause on the likelihood of frailty and the mediating role of age at menopause in older women: A population-based analysis from NHANES 1999–2018

Objectives

This study investigates the associations between surgical menopause, age at menopause, and frailty in older women. Furthermore, we examine whether age at menopause mediates the potential association between surgical menopause and frailty, and the extent of interaction or joint effects of surgical menopause and age at menopause on frailty.

Methods

The analysis included 7462 women aged ≥60 from the National Health and Nutrition Examination Survey 1999–2018. Frailty was measured using a 49-item frailty index and was diagnosed if the score on that index exceeded 0.21. Menopausal data were collected using a standardized reproductive health questionnaire. Survey-weighted logistic regression models were used to assess the association between surgical menopause, menopausal age, and frailty. We also conducted mediation analyses and interaction analyses on both the multiplicative and additive scales.

Results

Of the 7462 women, 2687 (32.4 %) had frailty. Women with a history of surgical menopause had an odds ratio (OR) of 1.44 (95 % CI: 1.25–1.66) for frailty compared to those with natural menopause. Age at menopause mediated 26.4 % of the total association between surgical menopause and frailty. No significant multiplicative or additive interactions were observed in the effects of type of menopause and age at menopause on frailty (Additive: Relative excess risk due to interaction = −0.01, 95 % CI: −0.32–0.31; Multiplicative, OR = 0.94, 95 % CI: 0.75–1.19). Joint ORs for individuals with both surgical and early menopause, compared with those with natural menopause and without early menopause, were 1.59 (95 % CI: 1.40–1.81) for frailty.

Conclusions

In postmenopausal women, surgical menopause was significantly associated with a higher likelihood of frailty than natural menopause. Age at menopause mediated more than 26 % of this association.

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来源期刊

Maturitas 医学-妇产科学

CiteScore

9.10

自引率

2.00%

发文量

142

审稿时长

40 days

期刊介绍： Maturitas is an international multidisciplinary peer reviewed scientific journal of midlife health and beyond publishing original research, reviews, consensus statements and guidelines, and mini-reviews. The journal provides a forum for all aspects of postreproductive health in both genders ranging from basic science to health and social care. Topic areas include:• Aging• Alternative and Complementary medicines• Arthritis and Bone Health• Cancer• Cardiovascular Health• Cognitive and Physical Functioning• Epidemiology, health and social care• Gynecology/ Reproductive Endocrinology• Nutrition/ Obesity Diabetes/ Metabolic Syndrome• Menopause, Ovarian Aging• Mental Health• Pharmacology• Sexuality• Quality of Life