Correlative Research Between Menopausal Hormone Therapy And The Risk Of Cardiovascular Disease

Objective: To investigate the factors related to the risk of thrombosis and subclinical atherosclerosis in different menopausal states in Shanghai,and to study the effect of tibolone on the risk of thrombosis in postmenopausal women.Methods: From December 2017 to December 2019,different menopausal status women aged 40-65 years and treated in the menopause clinic were enrolled,cross-sectional study and self-controlled study were conducted.Clinical data were collected by questionnaire survey,carotid ultrasound and Thrombelastography.Clinical intervention was performed on postmenopausal women with tibolone and follow-up for 1 year.The statistical methods included multivariate regression analysis and paired sample t test.Results:(1)The incidence of subclinical atherosclerosis was 33.5%,carotid plaque 21.4%.According to binary logistic regression analysis,age(P =0.021;OR=1.074)and HDL-C(P=0.028;OR=0.412)are risk factor for subclinical atherosclerosis;HDL-C(P =0.005;OR=0.257)and menopausal status(P=0.016;OR=0.374)are risk factor for plaque.Linear regression analysis showed that age(P=0.001;β=0.203)and BMI(P=0.016;β=0.153)are risk factor for the IMT in the right common carotid artery;BMI(P=0.020;β=0.150)are risk factor for the IMT in the left common carotid artery;(2)In the cross-sectional study based on the Thrombelastography,linear regression analysis found that FSH is related factors of R in both the menopausal transition period and the postmenopausal period(β=0.208;P=0.019);(β=0.178;P=0.027);KMI is related with K in the menopausal transition period(β=-0.245;P=0.019);Serum E2 affects K in the postmenopausal period(β=0.175;P=0.046);KMI is associated with ɑ in the menopausal transition period(β=0.288;P=0.002),TG is relevant to ɑ in the postmenopausal period(β=0.171;P=0.047);TG is risk factor for CI in the postmenopausal period(β=0.186;P=0.034).(3)Compared with the baseline level,the value of R decreased(-0.712)at 3 months after tibolone;the value of MA decreased(-3.581);the value of EPL is reduced(-2.035).At 12 months after tibolone,only MA decreased(-6.188).Conclusion: Carotid ultrasound is recommended for postmenopausal women with higher age,higher BMI and lower HDL-C.Menopause syndrome affects the blood clotting state in the body.Menopausal hormone replacement therapy may improve the symptoms of menopause,but the risk of thrombosis should also be paid attention to.