Epidemical Survey Of Depression Symptom In Perimenopausal Women And Association With The Polymorphism Of ERβ Gene

Menopause is an inevitable stage which every female must face,and is a process of gradual decline of ovarian function and estrogen level.Apart from hot flush and sweating,serious symptoms such as depression and anxiety will be encountered by women entering menopause.China,as well as the most part of the world,will become an aged society with the economical development.Psychological healthy status(like depression and anxiety) of senile women may become an important issue.Nowadays there is still lack of related data about affective factors,especially relating to women during menopausal transition and postmenopause.This study was designed to investigate the status of depression symptom and its association with estrogen and FSH levels,menopausal status,social support,quality of life and estrogen receptorβgene polymorphism in women during perimenopausal stage.Part One Epidemical survey of depression symptoms during perimenopausal stage in Beijing city.Objective:To investigate the prevalence of depression and anxiety symptoms and their influence factors in women during perimenopausal stage.Methods:A cross-sectional investigation was conducted with a composed questionnaire on general conditions,Kupperman Menopause Index,social support scoring,SF-36 scoring,self-evaluating depression and anxiety scoring.All of the parameters were input into a database and analyzed with t-test,x²,nonparametric test and logistic regression using SPSS.Results:A total of 1280 women aged 45-59 in Beijing city were interviewed with the questionnaire mentioned above.1)The mean age was 51.8 years old. Among them,487 subjects(38.0%) were in menopausal transition,394 subjects (30.8%) were in early menopausal stage,348 subjects(27.2%)were in late menopausal stage.2) The prevalence of depression and anxiety symptoms in these women was 306(23.9%) and 131(10.2%) respectively.There were no statistical difference of the prevalence of depression or anxiety symptom in menopausal transition,early menopausal and late menopausal stage(P＞0.05).3) Compared to normal women,women with depression or anxiety had lower SF-36 scores(P＜0.01).4) The social support score of depressive women was lower than normal women(P＜0.01),except in women with anxious.5) Risk factors associated with depression included poor family satisfaction, strait financial status,children failed in entering college or getting a job,poor social support,vaginal dryness or dyspareunia and hot flashes. Risk factors associated with anxiety included history of premenstrual dysphoric disorder(PMDD),hot flashes,vaginal dryness or dyspareunia and some negative social and family events.Conclusions:Depression and anxiety were common symptoms in Chinese women during perimenopausal stage.Some psycho-social factors may play a role in the prevalence of them.Women with depression or anxiety had poor quality of life.and women with depression had poor social supportPart Two Association between estrogen receptorβgene polymorphism and depressive symptom in women during perimenopause.Objective:To investigate whether estrogen receptorβgene polymorphism was associated with depressive symptom and climacteric symptoms in women during menopausal transition and postmenopause.Methods:SDS and Kupperman Menopause Index were used in rating depressive symptom and climacteric symptoms,respectively.Serum E₂ and FSH was measured with Electrochemiluminescence immunoassay(ECLIA).Estrogen receptorβgene polymorphism(AluI and RsaI) was assessed by polymerase chain reaction (PCR) and restriction fragment-length polymorphism analysis(RFLP). Polymerase chain reaction(PCR) and genotyper software was performed in testing the length of ERβgene microsatellites.These results were analyzed by t-test,x² and nonparametric test.Results:1) 165 women was recruited with mean age of 51.21±3.67 years. 2) There were 22 subjects with mild depressive symptom,15 subjects with moderate depressive symptom,9 subjects with severe depressive symptom and 119 subjects with no depressive symptom.It was revealed that there was no statistical relation between serum sex hormone,ERβRsaI and ERβAluI polymorpbism and depressive symptom.The length of CA repeating fragment in women with severe depression was significantly longer than those women with no or mild depression(P=0.008,P=0.009).3) There were 77 subjects with mild climacteric syndrome(Kupperman index≤15),63 subjects with moderate climacteric syndrome(Kupperman index 15-30) and 25 subjects with severe climacteric syndrome(Kupperman index≥31).Among those three groups, the level of serum E₂ had the trend to decline and the level of serum FSH had the trend to increase with the aggravation of climacteric syndrome during menopausal transition(P＜0.05).The degree of climacteric syndrome was not related to ERβgene polymorphism.RsaI gene polymorphism was related to palpitation and(CA)n gene polymorpbism was related to palpitation and dizziness.Conclusions:The length of ERβmicrosatellites may be associated with depressive symptom in women during menopausal transition and postmenopause. The degree of climacteric syndrome was associated with the level of serum E₂ and FSH during menopausal transition.Palpitation and dizziness may be associated with ERβgene polymorphism.