Carotid Plaque Formation And Its Related Factors In Pre- And Postmenopausal Women

Objective:To observe the Intima-media thickness and Carotid plaque in pre- and postmenopausal women with ultrasound. To analyse the causes and factors related to Carotid plaque.Methods:224 women aged 45-55 years old visited the Obstetrics outpatient and medical examination center of the first affiliated Hospital of Shanxi Medical University for routine examinations from March 2014 to August 2015. Investigated menstrual and reproductive history, body mass index(including height, weight, waist and hip circumference), biochemical parameters(including TC, TG, HDL, LDL and FPG)with face to face questionnaires, and examine carotid ultrasonographies(common carotid artery, carotid bifurcation, internal carotid artery proximal wall of three layer,including the intima, media and adventitia, measuring IMT and presence of atherosclerotic plaque, plaque size and nature). These people were divided into three groups according to the Stages of reproductive aging workshop + 10(STRAW + 10)staging system:-3 namely the later reproductive group(53 cases),- 2 and-1 namely the menopausal transition group(70 Example), +1 namely the early postmenopausal group(101 cases). These people were divided into three groups based on their carotid ultrasound results: normal carotid(164 cases), IMT thickening(27 cases) and carotid plaque(33 cases). Analyzed the different carotid IMT and plaque data between the various groups and the relevant factors present in the formation.Result:(1) The mean age of the 224 women were(49.7±4.5) years old. The percentagesof the later reproductive group, the menopausal transition group and the early postmenopausal group were respectively: 23.7%(53/224), 31.2%(70/224) and 45.1%(101/224). The mean ages were respectively:(47.0±4.0, 50.0±6.5, 52.0±4.0) years old. The average menopause age was(49.0±4.0) years old. The minimum was 46.4years old. The maximum was 54.3 years old; the number of mean years since menopause was(3.5±2.8) years, and the shortest number of years since menopause was 1.2 years, the longest menopause 6.5 years. There was 8 people smokers and 12 people drinkers. The average BMI was(23.30±2.75), WHR was(0.84±0.06), the percentage of obesity was 25.4%(57/224), the percentage of the abdominal obesity was 22.8%(51/224). The average systolic blood pressure was(115.8±14.2) mm Hg,diastolic blood pressure was(76.6±9.1)mm/Hg. Hypertension accounted for 18.3%(43/224). The average TC, TG, HDL and LDL was respectively:(5.11±0.92),(1.41±0.84),(1.48±0.47) and(2.78±0.99). Dyslipidemia(increase or decrease) in the total incidence rate was 18.4%(40/217), in which the TC, TG, LDL increased were respectively: 9.7%(21/217), 3.7%(8/217) and 4.6%(10/217). The HDL reduced4.6%(10/217). The mean FPG was(5.26 ± 1.51) mmol/L, fasting blood sugar accounted for 11.6%(26/224).(2) The carotid artery abnormal rate in the three group was respectively: 20.75%(11/53), 22.86%(16/70) and 32.67%(33/101). Of which the IMT thickening proportion was respectively: 7.55%(4/53), 8.57%(6/70) and16.83%(17/101), the mean IMT was(1.20± 0.22, 1.10± 0.15, 1.20 ± 0.20) mm;plaques proportion was 13.21%(7/53), 14.29%(10/70) and 15.83%(16/101), average Crouse score was(2.00±1.40, 2.00±1.13, 2.60±2.55). The proportions of unstable plaque were 14.3%(1/7), 70.0%(7/10), 25.0%(4/16). There were no significant difference among the 3 groups in IMT thickening and plaque(P>0.05). Each group IMT and Crouse score was not statistically significant(p>0.05). The plaque stability among 3 groups was statistically significant(p<0.05), the unstable plaque in menopausal transition was significantly higher than the other two groups.(3) There was 109 and 115 included in ≤50 years old and >50 years old group respectively,there were significant difference in carotid abnormal situations(p<0.05), IMTthickening and plaque in >50 years old group were significantly higher than ≤50.(4)In 224 cases, the normal carotid, IMT thickening and carotid plaquea accounted for respectively: 73.21%(164/224), 12.05%(27/224) and 14.73%(33/224); there were no significant difference in smoking, drinking, BMI, waist circumference, WHR, SBP,TC, HDL and FPG also had no significant difference(p>0.05). But for age, DBP, TG and LDL the difference was statistically significant(p <0.05). The age, DBP and LDL in IMT thickening groups were significantly higher than the normal group. The age,DBP, TG and LDL in carotid plaque cases were significantly higher than the normal group. The carotid packet to the dependent variable(carotid normal=0, IMT thickening=1, carotid artery plaque=2), age, smoking, drinking, Stages of reproductive aging workshop, BMI, WHR, SBP, DBP, TC, TG, HDL, LDL and FPG as independent variables, ordinal Logistic regression analysis showed: age(51-55 years old), diastolic blood pressure and LDL were the risk factors for IMT thickening,the OR values were 4.948, 14.397 and 3.209; age(51-55 years), LDL, TG were the risk factors for carotid plaque, the OR values were 3.979, 3.575 and 4.375.Conclusion:(1) From menopause transition to the early postmenopausal group, the carotid IMT thickening and plaque had an increasing trend, but not statistically significant;the IMT and Crouse score were not significantly different among 3 group; the proportion of unstable plaque in menopausal transition group was significantly higher than the other two groups;(2) The proportion of IMT thickening and plaque in >50years old were higher than ≤50;(3) The age, DBP, LDL in IMT thickening and carotid plaque group were significantly higher than the normal group, and the TG in plaque group was also higher than the normal group; the age, DBP and LDL were the risk factors for IMT; the age, LDL and TG were the risk factors for plaque.