Protective effect of hormone therapy among women with   hysterectomy/oophorectomy

doi:10.1093/humrep/dex017

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	Protective effect of hormone therapy among women with hysterectomy/oophorectomy
	Chen, L. ; Mishra, G. D. ; Dobson, A. J. ; Wilson, L. F. ; Jones, M. A.
刊名	HUMAN REPRODUCTION
	2017
关键词	menopausal hormone therapy mortality cardiovascular mortality longitudinal study RANDOMIZED CONTROLLED-TRIAL CARDIOVASCULAR-DISEASE POSTMENOPAUSAL WOMEN REPLACEMENT THERAPY HEALTH OUTCOMES HYSTERECTOMY RISK
DOI	10.1093/humrep/dex017
英文摘要	STUDY QUESTION: Does exposure to menopausal hormone therapy (MHT) in mid-aged women alter their risk of cardiovascular disease (CVD) mortality and all-cause mortality? SUMMARY ANSWER:MHT soon after menopause is unlikely to increase the risk of CVD mortality or all-cause mortality and may have a protective effect for women with hysterectomy/oophorectomy. WHAT IS KNOWN ALREADY:The balance of benefits and risks of MHT are currently unclear and may differ according to when treatment starts and whether women have an intact uterus. STUDY DESIGN, SIZE, DURATION:A total of 13 715 participants from the mid-aged population-based cohort (born 1946-1951) of the Australian Longitudinal Study on Women's Health (ALSWH) were followed from 1998 to 2013. PARTICIPANTS/MATERIALS, SETTING, METHODS:The measures included cardiovascular and all-cause mortality, exposure to MHT and menopausal status (based on 3-yearly self-reports). Electronic prescriptions data on MHT were also available from mid-2002 onwards. At each follow-up survey wave, participants were classified as: an existing user of MHT, an initiator of MHT or a non-initiator of MHT. MAIN RESULTS AND THE ROLE OF CHANCE:After adjusting for confounding variables, existing users of MHT had a reduced risk (hazard ratio 0.63; 95% CI, 0.43-0.92) of CVD mortality compared with non-initiators. Insufficient evidence of an association was identified for initiators of MHT (0.66; 0.35-1.24). For all-cause mortality, risks were reduced for both initiators (0.69; 0.55-0.87) and existing users (0.80; 0.70-0.91). In a subgroup analysis, women with hysterectomy/oophorectomy had lower risks of CVD mortality for both initiators (0.14; 0.02-0.98) and existing users (0.55; 0.34-0.90), but no evidence of an association was found for women whose MHT commenced during or after menopause. Similarly for all-cause mortality, only the women with hysterectomy/oophorectomy had lower risks for both initiators (0.47; 0.31-0.70) and existing users (0.69; 0.58-0.82). LIMITATIONS, REASONS FOR CAUTION:Limitations include the observational nature of the study, the small number of deaths, MHT use being self-reported and the classification of menopausal status also being based on self-reported information. STUDY FUNDING/COMPETING INTEREST(S):Women considering MHT soon after menopause can be reassured that the treatment is unlikely to increase their risk of CVD mortality or all-cause mortality. STUDY FUNDING/COMPETING INTEREST(S):The Australian Longitudinal Study on Women's Health is funded by the Australian Department of Health. G.D.M. is funded by the Australian Research Council Future Fellowship. L.C. was funded by a China scholarship council (CSC) graduate scholarship. All authors report no conflict of interest. TRIAL REGISTRATION NUMBER:N/A.; Australian Department of Health; Australian Research Council Future Fellowship.; China Scholarship Council (CSC) graduate scholarship; SCI(E); SSCI; ARTICLE; 4; 885-892; 32
语种	英语
内容类型	期刊论文
源URL	[http://ir.pku.edu.cn/handle/20.500.11897/469292]
专题	工学院
推荐引用方式 GB/T 7714	Chen, L.,Mishra, G. D.,Dobson, A. J.,et al. Protective effect of hormone therapy among women with hysterectomy/oophorectomy[J]. HUMAN REPRODUCTION,2017.
APA	Chen, L.,Mishra, G. D.,Dobson, A. J.,Wilson, L. F.,&Jones, M. A..(2017).Protective effect of hormone therapy among women with hysterectomy/oophorectomy.HUMAN REPRODUCTION.
MLA	Chen, L.,et al."Protective effect of hormone therapy among women with hysterectomy/oophorectomy".HUMAN REPRODUCTION (2017).