Investigation On Changes Of Risk Factors For Cardiovascular Diseases During The Aging Of Ovarian Function And Effect Of Lifestyle Intervention In Chinese Women

BackgroundCardiovascular diseases (CVD) are one of major threats to women’s health. Epidemiological studies suggest that menopause is associated with increase in CVD risk factors. However, whether changes in these risk factors were related to ovarian aging and chronological aging remains controversial. Meanwhile, there are few prospective studies mainly on the relationship between aging of ovarian function and risk factors for CVD in China. In this study, we investigated changes of risk factors for CVD during the aging of ovarian function in Chinese women and the effect of lifestyle intervention.The following sections were included in this study: Section one:Investigation on changes of risk factors for CVD during the aging of ovarain function in Chinese womenSection two:The effects of lifestyle intervention improve cardiovascular disease risk factors in menopausal transition and early-postmenopausal women in ChinaSection one:Investigation on changes of risk factors for CVD during the aging of ovarian function in Chinese womenObjective Investigate the changes of risk factors for CVD during aging of ovarian function in Chinese women.Methods Prospective study. To recruit women30-54years in eight communities in western Beijing from June to December2005, and from April to July2007. A total of426community-based healthy premenopausal or perimenopausal women were followed annually for up to5years. Measured CVD risk factors included body measurement variables(BMI, waist circumference, ratio of waist circumference to hip circumference, systolic pressure, diastolic pressure), fasting blood glucose, lipids (TC, TG, HDL-C and LDL-C) and body composition. Those risk factors were assessed in six annual serial measures.Menopause status was defined by the menstrual change criteria of the Stages of Reproductive Aging Workshop+10. Results1.CVD risk factors at baseline among premenopausal womenAt baseline, there were217(51.0%) women in reproductive phase,148(34.7%) women in early menopausal transition,61(14.3%) women in late menopausal transition. After adjusting for age and BMI, WC and WHR were higher among women in early menopausal transition than women in reproductive phase or late menopausal transition. And TC was higher among women in late menopausal transition than those in reproductive phase or early menopausal transition. There were no significant differences for other risk factors for CVD between different stages of STRAW+10.2. Changes of CVD risk factors during5years follow upThere are260women who had finished5years follow up. After average2.87years follow-up,37(14.2%) women were still in reproductive phase,87(33.4%) women in early menopausal transition,68(26.2%) women in late menopausal transition and68(26.2%) women reached early postmenopause.After adjusting for age and BMI, there were significant in WC, WHR, A/G, total fat mass ratio over the time period. But there were no significance in systolic blood pressure, diastolic blood pressure, fasting blood glucose, lipids (TC, TG, HDL-C, LDL-C), and trunk-leg fat mass ratio over the follow-up period. There was no significance for all CVD risk factors in different staging of STRAW+10.Adjusted for the important predictors--age, BMI, education level, and physicial activity, menopausal status was a significant and independent predictor of the increase in WC, WHR, TC, percent of body fat and A/G.Conclusions Both time (chronological aging) and ovarian aging contributed to substantial changes in WC, WHR, A/G, percent of body fat and TC in Chinese Women. But we need more research to investigate the relationship between BMI, blood pressure, blood glucose, TG, HDL-C, LDL-C with menopause.Section two:The effects of lifestyle intervention improve cardiovascular disease risk factors in menopausal transition and early-postmenopausal women in ChinaObjective The purpose of this study was to test the efficacy of a12months lifestyle intervention on CVD risk factors in menopausal transition and early-postmenopausal women in China.Methods One hundred healthy menopausal transition and early-postmenopausal women aged40-60years were randomly assigned to receive either lifestyle change (intervention group, n=53) or usual care (control group, n=47). Menopause status was defined by the menstrual change criteria of the Stages of Reproductive Aging Workshop+10based on the prospective menstrual calendars.Women in the intervention group were provided with a booklet and interview one by one at which time biophysical cardiovascular risk measures were taken in Women Health Center. Women were encouraged to followed healthy eating pattern and increased their aerobic activity (moderate,3day/week,40min/d). Women in the control group continued their normal activities.Weight, Body Mass Index (BMI), waist circumference(WC), Waist circumference to hip circumference ratio (WHR), body composition, blood pressure (BP), blood glucose and blood lipids were assessed at baseline and12-month. At3-month, Weight, BMI, WC, WHR, and BP were assessed. At6-month, Weight, BMI, WC, WHR, BP, blood glucose and blood lipids were assessed.Results The data from five biophysical outcome measures supported the efficacy of the intervention, with significant decreases seen in the women’s weight, BMI, WC, and WHR. At3-month, there were significant changes in weight(-0.28vs0.68, P=0.002), BMI(-0.06vs0.44, P=0.003), WC (-0.28vs1.43, P=0.001), WHR(-0.01vs0.01, P=0.045) between intervention group and control group. At6-month, there were significant changes in WC(-0.73vs1.02, P=0.012), WHR (-0.02vs-0.003, P=0.020) and Systolic blood pressure(SBP)(-7.52vs-0.63, P=0.012) between intervention group and control group. At12-month, there were significant changes in TC(-0.07vs0.03, P=0.045) and LDL-C (-0.13vs0.01, P=0.022) between intervention group and control group.Conclusions Lifestyle intervention may be an effective means for reducing cardiovascular risk in menopausal transition and early-postmenopausal women in China.