吉林省女性自然绝经年龄及其影响因素的调查分析

Survey analysis on age at natural menopause and its influencing factors among women in Jilin Province

目的：了解吉林省女性自然绝经年龄的状况，阐明影响吉林省女性自然绝经年龄的相关因素。方法：采用多阶段分层随机整群抽样方法，在吉林省9个市（州）共32个区／市／县选取18～79岁的23050名居民进行面对面的问卷调查及体格检查，实际完成有效样本21435名，共筛选出女性样本11098名，其中已自然绝经女性4875名作为本次研究样本。采用复杂加权方法估计平均自然绝经年龄和自然绝经年龄中位数，采用方差分析比较不同出生年份女性自然绝经年龄差异，并应用多元线性回归分析自然绝经年龄的影响因素。结果：吉林省女性平均自然绝经年龄为（49.11±4.19）岁，自然绝经年龄中位数为50.00岁，自然绝经者4881名，＜40岁绝经者111名（2.27％），40～45岁绝经者643名（13.17％），46～53岁绝经者3513名（71.97％），54岁以上绝经者573名（11.74％），另有41名（0.85％）绝经年龄缺失。不同出生年份（70～79岁为1933-1942年、60～69岁为1943-1952年、57～59岁为1953-1955年）女性自然绝经年龄比较显示，城市和农村不同年份出生女性自然绝经年龄比较差异均有统计学意义（F＝16.633，P＜0.001；F＝7.400，P＜0.001），未分地区女性自然绝经年龄比较差异有统计学意义（F＝21.178，P＜0.001），经 SNK法比较，3组女性自然绝经年龄两两之间比较差异均有统计学意义（P＜0.01），自然绝经年龄分别为1953-1955年出生组50.38岁、1943-1952年出生组49.51岁、1933-1942年出生组48.81岁；城市不同年份出生女性自然绝经年龄差异有统计学意义（F＝16.633，P＜0.001），经SNK-q检验比较，3组女性自然绝经年龄任意2组之间比较差异均有统计学意义（P＜0.05），自然绝经年龄分别为1953-1955年出生组50.77岁、1943-1952年出生组49.73岁和1933-1942年出生组48.85岁；农村不同年份出生女性自然绝经年龄比较差异有统计学意义（F＝7.400，P＝0.001），经 SNK-q检验比较，1953-1955年出生组与另外2组自然绝经年龄比较差异有统计学意义（P＜0.05），自然绝经年龄分别为1953-1955年出生组50.09岁、1943-1952年出生组49.33岁和1933-1942年出生组48.74岁。多元线性回归分析显示，体质量指数（BMI）、体育锻炼与女性自然绝经年龄呈正相关关系（r＝0.089， P＜0.001；r＝0.150，P＝0.025），吸烟、心理健康状况得分与女性自然绝经年龄呈负相关关系（r＝-0.257， P＝0.002；r＝-0.061，P＝0.016）。饮食因素，例如蔬菜、水果、牛奶、豆制品和肉类食用频率与自然绝经年龄无相关性。结论：吉林省不同出生年份的女性平均自然绝经年龄有差异；BMI、吸烟、心理健康状况和体育锻炼可能是女性自然绝经年龄的影响因素。

Objective To study the ages at natural menopause of the women in Jilin Province, and to illustrate its influencing factors among the women in Jilin Province.Methods Through multistage stratified cluster random sampling method,23 050 people aged from 18 to 79 years were drew from nine states（a total of 32 areas）of Jilin province.The data of these residents were collected with the questionnaire and physical examinations by face-to-face interview.The number of selected female sample was 11 098. Finally, 4 881 postmenopausal women were selected.Complex weighted computation was used to estimate the ages at natural menopause.One-way ANOVA was used to compare the ages at natural menopause of the women with different birth years. Multiple linear regression analysis were used to examine the influencing factors of the ages at natural menopause. Results The mean and median ages at natural menopause were （49.11±4.19）years and 50.00 years,respectively.There were 4 881 cases of postmenopausal women,among them the women with age at natural menopause〈40 years,40 year≤age at natural menopause≤45 years,46 years≤ age at natural menopause≤53 years,age at natural menopause≥54 years and age at natural menopause missing accounted for 2.27%（111 cases）,13.17%（643 cases）,71.97%（3 513 cases）,11.74% （573 cases）,and 0.85%（41 cases）,respectively.Converted to birth years by age,70-79 years old was 1933-1942 birth years,60-69 years old was 1943-1952 birth years and 57-59 years old was 1953-1955 birth years.The age at natural menopause in Jilin province was statistically significant among the women with different birth years（F=21.178,P〈0.001）.By SNK-q test among three different birth year groups, the age at natural menopause was different between any two groups among three different birth year groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.38 years,49.51 years and 48.81 years.The age at natural menopause in urban of Jilin province was statistically significant among the women with different birth years（F=16.633,P〈0.001）.By SNK-q test among three different birth year groups,the age at natural menopause was different between any two groups among three different birth year groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.77 years,49.73 years,and 48.85 years,respectively.The age at natural menopause in rural of Jilin province was statistically significant among the women with different birth years（F=7.400,P=0.001 ）. By SNK-q test among three different birth year groups, the age at natural menopause was different between 1953-1955 birth year group and the other two groups and the ages at natural menopause of 1953-1955 birth year group,1943-1952 birth year group and 1943-1952 birth year group were 50.09 years,49.33 years,and 48.74 years,respectively.The multiple linear regression results indicated that BMI and exercise were positively correlated with the age at natural menopause,but smoking and mental health evaluation were negatively.Consumption frequency of vegetables,fruits,bean products,and meat was no correlated with the age at natural menopause.Conclusion The differences of the ages at natural menopause between the women with different birth years are statistically significant in Jilin Province;BMI, smoking, exercise,and mental health are the influencing factors of the age at natural menopause.