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- Title
Trajectory clustering of estradiol and follicle-stimulating hormone during the menopausal transition among women in the Study of Women's Health across the Nation (SWAN).
- Authors
Tepper PG; Randolph JF Jr; McConnell DS; Crawford SL; El Khoudary SR; Joffe H; Gold EB; Zheng H; Bromberger JT; Sutton-Tyrrell K; Tepper, Ping G; Randolph, John F Jr; McConnell, Daniel S; Crawford, Sybil L; El Khoudary, Samar R; Joffe, Hadine; Gold, Ellen B; Zheng, Huiyong; Bromberger, Joyce T; Sutton-Tyrrell, Kim
- Abstract
<bold>Context: </bold>Variability in the pattern of change in estradiol (E2) and FSH levels over the menopause transition has not been well defined.<bold>Objective: </bold>The current study aimed to determine whether different trajectories of E2 and FSH could be identified and whether race/ethnicity and body mass index were related to the different trajectories.<bold>Design: </bold>The Study of Women's Health Across the Nation is a longitudinal observational study of the menopausal transition.<bold>Setting: </bold>Women aged 42-52 yr from seven participating sites were recruited and underwent up to 11 annual visits.<bold>Participants: </bold>Postmenopausal women with 12 or more months of amenorrhea that was not due to hysterectomy/oophorectomy and who were not using hormone therapy before the final menstrual period participated in the study.<bold>Main Outcome Measures: </bold>Annual serum E2 and FSH levels anchored to final menstrual period were measured.<bold>Results: </bold>Four distinct E2 trajectories and three distinct FSH trajectories were identified. The E2 trajectories were: slow decline (26.9%), flat (28.6%), rise/slow decline (13.1%), and rise/steep decline (31.5%). The FSH trajectories were: low (10.6%), medium (48.7%), and high (41.7%) rising patterns. Obesity increased the likelihood of a flat E2 and low FSH trajectory for all race/ethnic groups. Normal-weight Caucasian and African-American women tended to follow the rise/steep decline E2 and high FSH trajectories. Normal-weight Chinese/Japanese women tended to follow the slow decline E2 and the high/medium FSH trajectories.<bold>Conclusions: </bold>E2 and FSH trajectories over the menopausal transition are not uniform across the population of women. Race/ethnicity and body mass index affect the trajectory of both E2 and FSH change over the menopausal transition.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2012, Vol 97, Issue 8, p2872
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/jc.2012-1422