Maturitas最新文献_第4页

Association of lifestyle and non-lifestyle variables with fertility problems in a population-based cohort of women in Australia 澳大利亚以人口为基础的妇女队列中生活方式和非生活方式变量与生育问题的关联。

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-16 DOI: 10.1016/j.maturitas.2026.108833

Gabriela P. Mena , Shalem Leemaqz , Allison Hodge , Jessica A. Grieger

Objectives

To assess the relative importance of a range of lifestyle and non-lifestyle variables in relation to the risk of fertility problems over time.

Study design

A prospective cohort study using data from the 1973–1978 birth cohort of women participating in the Australian Longitudinal Study of Women's Health.

Main outcome measures

Women who completed at least one survey between 2006 (used as baseline) and 2018 and who reported a known fertility status were included (n = 8475). Participants were aged 28–33 years in 2006. Exposure variables included age, body mass index (BMI), polycystic ovary syndrome (PCOS), physical activity, fruit and vegetable intake, smoking and alcohol, and level of anxiety. Women were asked to report their fertility status, categorised as “fertility problems” (with or without treatment) and “no fertility problems”. A generalised estimating equation with log-binomial family was fitted, and the estimated probabilities along with 95% confidence intervals were obtained. The relative contribution of each variable to infertility was estimated by multimodel inference.

Results

The mean (SD) age and BMI of the 8475 women included was 33.2 (3.5) years and 25.9 (6.0) kg/m²; of the sample, 24% had problems with fertility. Age, PCOS, anxiety, BMI, and the interaction of age x PCOS had the same relative contribution, of 8.5%, to the risk of fertility problems at any given point across the 12 years. When the contributions of age with any of the exposures (except PCOS) were explored together, the relative contribution was less than that of the respective individual exposures, indicating that their interaction weakly contributes to fertility problems.

Conclusions

BMI and anxiety contributed independently of age to infertility problems whereas the effect of PCOS was exacerbated with younger age. These findings highlight the importance of early pregnancy planning, particularly for women with PCOS, and support the need for preconception strategies targeting BMI and anxiety. However, temporal misalignment between current exposures and lifetime infertility reporting may limit causal interpretation.

目的：评估一系列生活方式和非生活方式变量对生育问题风险的相对重要性。研究设计：一项前瞻性队列研究，使用1973-1978年参加澳大利亚妇女健康纵向研究的妇女出生队列的数据。主要结果测量：包括在2006年（作为基线）至2018年期间完成至少一次调查并报告已知生育状况的妇女（n = 8475）。参与者在2006年的年龄为28-33岁。暴露变量包括年龄、体重指数（BMI）、多囊卵巢综合征（PCOS）、体力活动、水果和蔬菜摄入量、吸烟和饮酒以及焦虑水平。妇女被要求报告她们的生育状况，分为“生育问题”（接受或未接受治疗）和“无生育问题”。拟合了对数二项族的广义估计方程，得到了估计概率和95%置信区间。通过多模型推断估计每个变量对不孕症的相对贡献。结果：8475名女性的平均（SD）年龄和BMI分别为33.2（3.5）岁和25.9 (6.0)kg/m2；在样本中，24%的人有生育问题。年龄、多囊卵巢综合征、焦虑、体重指数以及年龄与多囊卵巢综合征的相互作用在12年中任何给定时间点对生育问题风险的相对贡献相同，均为8.5%。当年龄与任何暴露（PCOS除外）的贡献一起研究时，相对贡献小于各自个体暴露的贡献，表明它们的相互作用对生育问题的贡献较弱。结论：BMI和焦虑对不孕问题的影响与年龄无关，而PCOS的影响随着年龄的增长而加剧。这些发现强调了早孕计划的重要性，特别是对患有多囊卵巢综合征的妇女，并支持针对BMI和焦虑的孕前策略的必要性。然而，当前暴露与终生不孕症报告之间的时间偏差可能限制因果解释。

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引用次数: 0

Home-based exercise reduces fall risk in older adults with mild cognitive impairment who have sustained a hip fracture: A 6-month randomized controlled trial 一项为期6个月的随机对照试验：在家锻炼可以降低髋部骨折的轻度认知障碍老年人跌倒的风险

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-12 DOI: 10.1016/j.maturitas.2026.108832

Jordyn Rice , Ryan S. Falck , Yeon Soo Seo , Larry Dian , Jennifer C. Davis , Deborah A. Jehu , Naaz Parmar , Kenneth Madden , Pierre Guy , Darren Roffey , Teresa Liu-Ambrose

Objectives

Falls cause more than 85% of hip fractures in older adults. Older adults with cognitive impairment have been largely excluded from research on people who have sustained a hip fracture. As a consequence, whether exercise reduces fall risk in this high-risk population is unknown. We address this gap by examining the effect of a home-based exercise program on fall risk in older adults with mild cognitive impairment after hip fracture.

Methods

This was a 6-month randomized controlled trial comparing the effect of the Otago Exercise Program (OEP) versus standard care (SC) on fall risk measured with the Physiological Profile Assessment. Participants with mild cognitive impairment (Montreal Cognitive Assessment score <26/30 and no dementia) who sustained a hip fracture were included. Secondary outcomes included the Short Physical Performance Battery, gait speed, Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test immediate and delayed recall, and Clinical Frailty Scale.

Results

Sixty participants, mean age 80 years (SD 7 years), were randomized (OEP, n = 30; SC, n = 30). At 6 months, compared with SC participants, OEP participants had significantly better Physiological Profile Assessment performance (estimated mean difference −0.73; 95% CI [−1.45, −0.11]; p = 0.048), delayed recall performance (estimated mean difference 1.11; 95% CI [0.14, 2.09]; p = 0.025), and Clinical Frailty scores (estimated mean difference −0.71; 95% CI [−1.40, −0.01]; p = 0.046). There were no effects of the intervention on other secondary outcomes at 6 months.

Conclusions

The Otago Exercise Program was efficacious at reducing fall risk in older adults with mild cognitive impairment after hip fracture. Exercise also improved cognitive function and frailty, highlighting its critical role in recovery after hip fracture in this high-risk population.

在老年人中，超过85%的髋部骨折是由跌倒引起的。有认知障碍的老年人基本上被排除在对髋部骨折患者的研究之外。因此，在这一高危人群中，运动是否能降低跌倒风险还不得而知。我们通过研究以家庭为基础的锻炼项目对髋部骨折后轻度认知障碍的老年人跌倒风险的影响来解决这一差距。方法：这是一项为期6个月的随机对照试验，比较奥塔哥运动计划（OEP）与标准护理（SC）对跌倒风险的影响，采用生理特征评估法测量。患有轻度认知障碍（蒙特利尔认知评估评分<；26/30，无痴呆）且髋部骨折的参与者被纳入研究。次要结果包括短体能测试、步态速度、数字符号替代测试、Rey听觉语言学习测试、即时和延迟回忆以及临床虚弱量表。结果随机选取60例参与者，平均年龄80岁（SD 7岁）（OEP, n = 30； SC, n = 30）。在6个月时，与SC参与者相比，OEP参与者的生理特征评估表现（估计平均差异为- 0.73;95% CI [- 1.45, - 0.11]; p = 0.048）、延迟回忆表现（估计平均差异为1.11;95% CI [0.14, 2.09]; p = 0.025）和临床虚弱评分（估计平均差异为- 0.71;95% CI [- 1.40, - 0.01]; p = 0.046）显著更好。6个月时，干预对其他次要结局没有影响。结论：奥塔哥运动项目可有效降低髋部骨折后轻度认知障碍的老年人跌倒风险。运动还能改善认知功能和虚弱，突出了它在高危人群髋部骨折后康复中的关键作用。

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引用次数: 0

Frailty transitions and relevant factors in midlife: A longitudinal analysis of the ELSA cohort with multi-state Markov models 中年衰弱转变及相关因素：ELSA队列的多状态马尔可夫模型纵向分析

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-10 DOI: 10.1016/j.maturitas.2026.108825

Jinzhu Yang , Mingyue Gao , Linjun Jiang , Yue Li , Lingxiao He

Background

Frailty is an ageing-related health condition, but it is not restricted to older adults. Understanding the characteristics of frailty transitions and relevant factors in midlife would benefit frailty prevention and management later in life.

Methods

Data on 3405 participants aged between 50 and 64 were selected from the English Longitudinal Study of Ageing (ELSA) across six waves (2008–2018). Frailty status at each wave was evaluated by a 52-item frailty index (FI), defining frailty as FI ≥ 0.25, pre-frailty as FI ≥ 0.12 and robustness as FI < 0.12. Multi-state Markov models were constructed to explore frailty transitions, and socioeconomic, behavioral and nutritional factors related to changes in frailty status.

Results

The incidence and improvement rates of frailty were 5.23 and 1.15 per 100 person-years, respectively. Among socioeconomic factors, high gross wealth (HR = 1.61, 95%CI [1.12, 2.33]) increased the likelihood of transition from frailty to pre-frailty. Among behavioral factors, using the internet (HR = 0.65, 95%CI [0.53, 0.80]) inhibited the progression from robustness to pre-frailty. Regular alcohol consumption (HR = 1.55, 95%CI [1.14, 2.11]) promoted a shift from pre-frailty to robustness. Living with others (HR = 0.52, 95%CI [0.39, 0.69]) and participating in voluntary activities (HR = 0.86, 95%CI [0.80, 0.94]) lessened progression from pre-frailty to frailty. Moderate (HR = 2.49, 95%CI [1.50, 4.14]) and vigorous (HR = 2.93, 95%CI [1.42, 6.07]) physical activity promoted the transition from frailty to pre-frailty. Among nutrition-related factors, high hemoglobin concentration (HR = 0.15, 95%CI [0.05, 0.47]) inhibited the development from robustness to frailty.

Conclusion

Encouraging healthy lifestyle, active social participation, and balanced nutrition may be beneficial to middle-aged people in diminishing the development of frailty.

背景：虚弱是一种与年龄相关的健康状况，但它并不局限于老年人。了解中年衰弱转变的特点及相关因素，有助于今后预防和管理衰弱。方法从英国老龄化纵向研究（ELSA）六波（2008-2018）中选取3405名年龄在50至64岁之间的参与者的数据。采用52项脆弱指数（FI）评价每一波的脆弱状态，定义FI≥0.25为脆弱，FI≥0.12为预脆弱，FI <； 0.12为稳健性。构建多状态马尔可夫模型，探讨脆弱状态变化的社会经济、行为和营养因素。结果衰弱发生率为5.23例/ 100人年，改善率为1.15例/ 100人年。在社会经济因素中，高总财富（HR = 1.61, 95%CI[1.12, 2.33]）增加了从脆弱向脆弱前过渡的可能性。在行为因素中，使用互联网（HR = 0.65, 95%CI[0.53, 0.80]）抑制了从健壮到虚弱前的进展。经常饮酒（HR = 1.55, 95%CI[1.14, 2.11]）促进了从脆弱前期到健壮性的转变。与他人一起生活（HR = 0.52, 95%CI[0.39, 0.69]）和参加志愿活动（HR = 0.86, 95%CI[0.80, 0.94]）可减少从前期虚弱到虚弱的进展。中度体力活动（HR = 2.49, 95%CI[1.50, 4.14]）和剧烈体力活动（HR = 2.93, 95%CI[1.42, 6.07]）促进了从虚弱到虚弱前期的转变。在营养相关因素中，高血红蛋白浓度（HR = 0.15, 95%CI[0.05, 0.47]）抑制了健壮向虚弱的发育。结论提倡健康的生活方式，积极参与社会活动，营养均衡，有利于中年人减少虚弱的发生。

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引用次数: 0

Risk of thyroid disorders after diagnosis of endometriosis: A 20-year retrospective cohort study 子宫内膜异位症诊断后甲状腺功能障碍的风险：一项20年回顾性队列研究

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-10 DOI: 10.1016/j.maturitas.2026.108824

Yu-Hsiang Shih , Chien-Hsing Lu , Chia-Chi Lung

Background

Emerging evidence suggests a potential link between endometriosis and thyroid disorders; however, long-term risks remain understudied.

Methods

We conducted a retrospective cohort study using data from the TriNetX global Collaborative Network. Women aged 21–60 with endometriosis who received surgical or pharmacologic treatment were included in the endometriosis cohort. The comparison cohort comprised women without endometriosis who had undergone pelvic ultrasonography. Patients with pre-existing metabolic, cardiovascular, autoimmune, or thyroid conditions were excluded. Propensity score matching was performed based on demographic characteristics and clinical factors.

Results

After 1:1 matching, 118,360 patients were included. Over a 20-year follow-up, the endometriosis group had significantly higher risks of several thyroid conditions, including hypothyroidism (HR 1.19; 95% CI 1.13–1.25), hyperthyroidism (HR 1.21; 95% CI 1.09–1.35), Graves' disease (HR 1.27; 95% CI 1.04–1.56), non-toxic goiter (HR 1.31; 95% CI 1.23–1.39), thyroiditis (HR 1.32; 95% CI 1.18–1.48), and both malignant (HR 1.55; 95% CI 1.21–1.97) and benign (HR 2.47; 95% CI 1.73–3.52) thyroid neoplasms. The risk of thyroid disease did not differ significantly between women who received medical management and those who received surgical management, suggesting that the association may be intrinsic to endometriosis rather than treatment-related. Additionally, a history of delivery was associated with an increased risk of hypothyroidism (HR 1.39; 95% CI 1.17–1.66).

Conclusion

Endometriosis is associated with an elevated long-term risk of diverse thyroid diseases. These findings highlight the need for proactive thyroid monitoring in patients with endometriosis.

背景：越来越多的证据表明子宫内膜异位症与甲状腺疾病之间存在潜在联系；然而，长期风险仍未得到充分研究。方法采用TriNetX全球协作网络的数据进行回顾性队列研究。接受手术或药物治疗的21-60岁子宫内膜异位症妇女被纳入子宫内膜异位症队列。比较队列包括接受盆腔超声检查的无子宫内膜异位症的妇女。已存在代谢、心血管、自身免疫或甲状腺疾病的患者被排除在外。根据人口学特征和临床因素进行倾向评分匹配。结果经1:1匹配，纳入患者118360例。在20年的随访中，子宫内膜异位症组发生几种甲状腺疾病的风险明显更高，包括甲状腺功能减退（HR 1.19; 95% CI 1.13-1.25）、甲状腺功能亢进（HR 1.21; 95% CI 1.09-1.35）、Graves病（HR 1.27; 95% CI 1.04-1.56）、无毒甲状腺肿（HR 1.31; 95% CI 1.23-1.39）、甲状腺炎（HR 1.32; 95% CI 1.18-1.48）以及恶性（HR 1.55; 95% CI 1.21 - 1.97）和良性（HR 2.47; 95% CI 1.73-3.52）甲状腺肿瘤。甲状腺疾病的风险在接受内科治疗的妇女和接受外科治疗的妇女之间没有显著差异，这表明这种关联可能是子宫内膜异位症的内在因素，而不是治疗相关。此外，分娩史与甲状腺功能减退的风险增加相关（HR 1.39; 95% CI 1.17-1.66）。结论子宫内膜异位症与多种甲状腺疾病的长期发病风险增高有关。这些发现强调了对子宫内膜异位症患者进行主动甲状腺监测的必要性。

{"title":"Risk of thyroid disorders after diagnosis of endometriosis: A 20-year retrospective cohort study","authors":"Yu-Hsiang Shih , Chien-Hsing Lu , Chia-Chi Lung","doi":"10.1016/j.maturitas.2026.108824","DOIUrl":"10.1016/j.maturitas.2026.108824","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence suggests a potential link between endometriosis and thyroid disorders; however, long-term risks remain understudied.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using data from the TriNetX global Collaborative Network. Women aged 21–60 with endometriosis who received surgical or pharmacologic treatment were included in the endometriosis cohort. The comparison cohort comprised women without endometriosis who had undergone pelvic ultrasonography. Patients with pre-existing metabolic, cardiovascular, autoimmune, or thyroid conditions were excluded. Propensity score matching was performed based on demographic characteristics and clinical factors.</div></div><div><h3>Results</h3><div>After 1:1 matching, 118,360 patients were included. Over a 20-year follow-up, the endometriosis group had significantly higher risks of several thyroid conditions, including hypothyroidism (HR 1.19; 95% CI 1.13–1.25), hyperthyroidism (HR 1.21; 95% CI 1.09–1.35), Graves' disease (HR 1.27; 95% CI 1.04–1.56), non-toxic goiter (HR 1.31; 95% CI 1.23–1.39), thyroiditis (HR 1.32; 95% CI 1.18–1.48), and both malignant (HR 1.55; 95% CI 1.21–1.97) and benign (HR 2.47; 95% CI 1.73–3.52) thyroid neoplasms. The risk of thyroid disease did not differ significantly between women who received medical management and those who received surgical management, suggesting that the association may be intrinsic to endometriosis rather than treatment-related. Additionally, a history of delivery was associated with an increased risk of hypothyroidism (HR 1.39; 95% CI 1.17–1.66).</div></div><div><h3>Conclusion</h3><div>Endometriosis is associated with an elevated long-term risk of diverse thyroid diseases. These findings highlight the need for proactive thyroid monitoring in patients with endometriosis.</div></div>","PeriodicalId":51120,"journal":{"name":"Maturitas","volume":"206 ","pages":"Article 108824"},"PeriodicalIF":3.6,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Associations of DNA methylation algorithm measures of aging with type 2 diabetes and mortality risk among US older adults DNA甲基化算法测量衰老与美国老年人2型糖尿病和死亡风险的关系

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-09 DOI: 10.1016/j.maturitas.2026.108827

Xuetong Zhao , Chongyu Ding , Hui Zhang , Yaqian Xu , Yulu Gong , Darong Hao , Zhaojun Wang , Xiangwei Li

Background

DNA methylation algorithm values show promise as biomarkers for aging and adverse health outcomes, However, their comparative predictive utility for type 2 diabetes mellitus and its related mortality remains inadequately characterized. This study systematically evaluated twelve established epigenetic algorithms to address this knowledge gap.

Methods

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) 1999–2002, we assessed twelve DNA methylation algorithms (e.g., PhenoAgeAcc, GrimAgeMortAcc, GrimAge2MortAcc) in relation to type 2 diabetes mellitus risk and mortality among 2532 participants aged 50 years or more. DNA methylation was measured using the Infinium Methylation EPIC BeadChip kit. Statistical models quantified effect estimates as odds ratios for type 2 diabetes mellitus risk and subdistribution hazard ratios for mortality, with 95% confidence intervals expressed per one-standard deviation increment in epigenetic age Acceleration metrics.

Results

Significant associations were observed for PhenoAgeAcc, GrimAgeMortAcc, and GrimAge2MortAcc with type 2 diabetes mellitus risk, with multivariable-adjusted odds ratios (95% confidence interval) per standard deviation increase of 1.24 (1.04–1.49), 2.08 (1.39–3.13), and 2.95 (1.97–4.43), respectively. These associations remained consistent across biological sex and age subgroups (50–64 vs. ≥65 years). For mortality risk, eight algorithm measures were positively associated with type 2 diabetes mellitus mortality, with GrimAgeMortAcc and GrimAge2MortAcc showing the strongest predictive performance, with adjusted subdistribution hazard ratios (95% confidence interval) per standard deviation increase of 1.61 (1.39–1.87) and 1.69 (1.48–1.93), respectively.

Conclusions

DNA methylation algorithm values, particularly GrimAgeMortAcc and GrimAge2MortAcc, are strongly associated with prevalent type 2 diabetes mellitus and show significant utility for mortality risk stratification, highlighting the potential of these algorithms as tools for identifying high-risk populations. These findings highlight the potential of epigenetic biomarkers in guiding targeted prevention strategies.

dna甲基化算法值有望作为衰老和不良健康结果的生物标志物，然而，它们对2型糖尿病及其相关死亡率的比较预测效用仍然没有充分的表征。本研究系统地评估了12种已建立的表观遗传算法来解决这一知识差距。方法利用1999-2002年全国健康与营养调查（NHANES）的数据，对2532名年龄在50岁及以上的参与者进行了12种DNA甲基化算法（如PhenoAgeAcc、GrimAgeMortAcc、GrimAge2MortAcc）与2型糖尿病风险和死亡率的关系进行了评估。使用Infinium methylation EPIC BeadChip试剂盒检测DNA甲基化。统计模型将效应估计量化为2型糖尿病风险的优势比和死亡率的亚分布风险比，95%的置信区间表示表观遗传年龄加速指标的每一个标准差增量。结果PhenoAgeAcc、GrimAgeMortAcc和GrimAge2MortAcc与2型糖尿病风险显著相关，多变量校正比值比（95%置信区间）每标准差分别增加1.24（1.04-1.49）、2.08（1.39-3.13）和2.95（1.97-4.43）。这些关联在生理性别和年龄亚组（50-64岁vs.≥65岁）中保持一致。对于死亡风险，8项算法指标与2型糖尿病死亡率呈正相关，其中GrimAgeMortAcc和GrimAge2MortAcc的预测效果最强，每标准差调整后的亚分布风险比（95%置信区间）分别增加1.61（1.39-1.87）和1.69（1.48-1.93）。结论dna甲基化算法值，特别是GrimAgeMortAcc和GrimAge2MortAcc，与2型糖尿病的流行密切相关，并在死亡率风险分层中显示出显著的效用，突出了这些算法作为识别高危人群工具的潜力。这些发现突出了表观遗传生物标志物在指导有针对性的预防策略方面的潜力。

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引用次数: 0

Impact of long-term medication on estrobolome-associated β-glucuronidase and sulfatase activities: Implications for estrogen homeostasis in postmenopausal women 长期用药对雌激素相关β-葡萄糖醛酸酶和硫酸酯酶活性的影响：对绝经后妇女雌激素稳态的影响

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-09 DOI: 10.1016/j.maturitas.2026.108830

María Elena Martínez-Nortes , Concepción Carrascosa-Romero , María Ángeles Ávila-Gálvez , Juan Carlos Espín

Menopause leads to a decline in circulating estrogen levels, increasing cardiometabolic risk, contributing to bone loss, and decreasing quality of life. The estrobolome, a subset of microbes with β-glucuronidase (GUS) and sulfatase activities, regulates estrogen homeostasis through deconjugation and enterohepatic recycling, thereby influencing systemic estrogen availability. Common long-term pharmacological treatments in postmenopausal women may alter gut microbial composition and function, potentially affecting estrobolome activity and systemic estrogen levels.

This narrative review examines current evidence on how long-term pharmacological treatments may affect estrobolome-associated GUS and sulfatase activities, with implications for estrogen metabolism and health outcomes in postmenopausal women. A targeted literature search was performed to identify clinical studies on commonly prescribed drugs for hypertension, diabetes, dyslipidemia, osteoporosis, and depression in postmenopausal women, focusing on microbial taxa with reported GUS or sulfatase activity.

Among the evaluated pharmacological classes, antidiabetic drugs, particularly metformin, are the most extensively studied, followed by antidepressants. These treatments can modulate key gut bacterial genera with GUS and sulfatase activities, including Bifidobacterium, Roseburia, Faecalibacterium, and Clostridium, which are relevant to metabolic and estrogen homeostasis. However, no studies have directly assessed the impact of pharmacological treatments on GUS and sulfatase activity in postmenopausal women.

Understanding how chronic medication influences estrobolome dynamics may help identify strategies to support estrogen balance and improve systemic metabolic, hormonal, vascular, and inflammatory profiles. This review highlights the interplay between long-term medication, gut microbiota, and estrogen homeostasis as a promising avenue for personalized microbiota-targeted therapies in postmenopausal health.

更年期导致循环雌激素水平下降，增加心脏代谢风险，导致骨质流失，降低生活质量。雌激素组是一类具有β-葡萄糖醛酸酶（GUS）和硫酸酯酶活性的微生物，通过解结和肠肝循环调节雌激素稳态，从而影响全身雌激素的可用性。绝经后妇女常见的长期药物治疗可能改变肠道微生物组成和功能，潜在地影响雌激素活性和全身雌激素水平。这篇叙述性综述研究了目前关于长期药物治疗如何影响雌激素相关GUS和硫酸酯酶活性的证据，以及对绝经后妇女雌激素代谢和健康结果的影响。针对绝经后妇女高血压、糖尿病、血脂异常、骨质疏松和抑郁症常用处方药的临床研究进行了针对性的文献检索，重点关注已报道的GUS或硫酸酯酶活性的微生物类群。在评估的药理学类别中，降糖药，特别是二甲双胍，是研究最广泛的，其次是抗抑郁药。这些处理可以调节与代谢和雌激素稳态相关的双歧杆菌、Roseburia、Faecalibacterium和Clostridium等具有GUS和硫酸盐酶活性的关键肠道细菌属。然而，没有研究直接评估药物治疗对绝经后妇女GUS和硫酸酯酶活性的影响。了解慢性药物如何影响雌激素动力学可能有助于确定支持雌激素平衡和改善全身代谢、激素、血管和炎症谱的策略。这篇综述强调了长期用药、肠道微生物群和雌激素稳态之间的相互作用，作为绝经后健康个性化微生物群靶向治疗的有希望的途径。

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引用次数: 0

Menopause and multiple sclerosis: A scoping review of symptoms, disease course, and lived experience 更年期和多发性硬化症：症状，病程和生活经验的范围审查。

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-08 DOI: 10.1016/j.maturitas.2026.108826

Dawn Morgan , Victoria Aviado Flores , Stephanie Buxhoeveden , Robert Motl , Natalie Brounsuzian , Alexandra Christina Simpson , Jennifer Hill , Yolanda Hardy , Cristina Almeida Flores Román

Menopause influences disease activity in women with multiple sclerosis. This scoping review mapped current evidence on menopause in women with multiple sclerosis across symptom, disease, biological, and lived experience domains. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses and was preregistered on Open Science Framework (DOI 10.17605/OSF.IO/H8QBM). PubMed/MEDLINE, Embase, Web of Science, Scopus, CINAHL, and PsycINFO were searched for studies between January 1, 2018, and April 29, 2025. Two reviewers independently screened records with third-party adjudication. Eligible studies included women with multiple sclerosis (peri-, menopausal, or postmenopausal) and examined menopause-related outcomes. Data were synthesized descriptively across four domains: symptomatology, disease course, biological mechanisms, and quantitative patient perspectives. Of 7862 records, 19 studies were included, of which 18 were observational (cross-sectional, retrospective, longitudinal) and one a feasibility trial of menopausal hormone therapy. Menopause definitions varied (≥12 months amenorrhea, self-reported, biological, or analytic/time-varying). Most participants had relapsing-remitting multiple sclerosis with mild to moderate disability. Relapse activity declined after menopause, whereas indices of neurodegeneration and functional decline worsened. Symptoms often intensified and overlapped with aging. No studies captured patient perspectives using qualitative or mixed-method designs and relied solely on patient-reported outcomes. Evidence suggests menopause may accelerate multiple sclerosis progression, with reduced inflammation but greater neurodegeneration and symptom burden. Research is constrained by heterogeneity in accounting for age, inconsistent menopause definitions, and lack of qualitative studies. Clinicians should recognize overlapping menopausal and multiple sclerosis symptoms to inform individualized care. Future priorities include standardized menopause definitions and age-specific analytic frameworks in future mechanistic and qualitative MS research.

更年期影响多发性硬化症妇女的疾病活动。本综述从症状、疾病、生物学和生活经验等方面对多发性硬化症妇女绝经期的现有证据进行了综述。本综述遵循系统评价和荟萃分析的首选报告项目，并在开放科学框架（DOI 10.17605/OSF.IO/H8QBM）上预注册。检索了2018年1月1日至2025年4月29日之间的研究，检索了PubMed/MEDLINE、Embase、Web of Science、Scopus、CINAHL和PsycINFO。两名审稿人通过第三方裁决独立筛选记录。符合条件的研究包括患有多发性硬化症的妇女（围绝经期、绝经期或绝经后），并检查了与绝经相关的结果。描述性地综合了四个领域的数据：症状学、病程、生物学机制和定量患者观点。在7862份记录中，纳入了19项研究，其中18项是观察性的（横断面、回顾性、纵向），1项是绝经期激素治疗的可行性试验。更年期的定义各不相同（≥12个月闭经，自我报告的，生物学的，或分析的/时变的）。大多数参与者患有复发缓解型多发性硬化症，伴有轻度至中度残疾。绝经后复发率下降，神经退行性变和功能下降指标加重。症状往往随着年龄的增长而加剧和重叠。没有研究使用定性或混合方法设计捕获患者的观点，并仅依赖于患者报告的结果。有证据表明，更年期可能加速多发性硬化症的进展，减少炎症，但更大的神经变性和症状负担。研究受到年龄的异质性、不一致的更年期定义和缺乏定性研究的限制。临床医生应该认识到重叠的更年期和多发性硬化症症状，告知个体化护理。未来的优先事项包括标准化更年期定义和年龄特异性分析框架在未来的机制和质谱研究。

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引用次数: 0

Bidirectional transitions of depressive symptoms among middle-aged and older Chinese adults: A multi-state Markov model analysis 中国中老年人抑郁症状的双向转变：一个多状态马尔可夫模型分析

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-03 DOI: 10.1016/j.maturitas.2025.108822

Junmin Zhu , Chongtao Wei , Yafei Wu , Huanglong Chen , Yutao Lin , Zongjie Wang , Ya Fang

Objective

Evidence on bidirectional transitions of mid- to late-life depressive symptoms and their determinants remains limited. This study aimed to characterize the progression and remission of depressive symptoms in Chinese middle-aged and older adults and to identify modifiable risk factors.

Methods

Data from the China Health and Retirement Longitudinal Study (2011−2020) were utilized, including 13,921 participants aged ≥45 years with at least 2 assessments using the Center for Epidemiologic Studies Depression Scale (CESD-10). Depressive symptoms were defined as a CESD-10 score ≥ 10. Continuous-time multi-state Markov models estimated transition intensities, probabilities, and mean sojourn times. Multivariable models provided transition-specific hazard ratios (HRs).

Results

Among 45,102 observed transitions, remission intensity exceeded progression intensity (0.255 vs 0.154 per year). The mean sojourn time was longer for non-depressive symptoms than for depressive symptoms (5.241 vs 3.238 years). At 5 years, remission probability was 43.40 % while progression was 26.20 %. Female sex, lower economic status, multimorbidity, limitations in activities of daily living, and short sleep predicted higher progression, with HRs of 1.320, 1.251, 1.238, 1.264, 1.283, respectively, and lower remission, with HRs of 0.816, 0.859, 0.854, 0.830, 0.855, respectively. Falls (HR = 1.147) and smoking (HR = 1.109) increased progression. Urban residence, higher levels of education, participation in activities, and greater life satisfaction reduced progression, with HRs of 0.724, 0.717, 0.842, 0.770, respectively, while urban residence, greater life satisfaction, and drinking at least once per month increased remission, with HRs of 1.109, 1.235, 1.151, respectively.

Conclusion

Depressive symptoms in mid- to late life were bidirectional and potentially reversible. Socioeconomic disadvantage, multimorbidity, and functional impairment shaped unfavorable transitions, while modifiable behaviors and subjective well-being related to improved remission.

目的：关于中晚期抑郁症状及其决定因素的双向转变的证据仍然有限。本研究旨在描述中国中老年人抑郁症状的进展和缓解，并确定可改变的危险因素。方法：使用中国健康与退休纵向研究（2011-2020）的数据，包括13921名年龄≥45岁的参与者，使用流行病学研究中心抑郁量表（CESD-10）进行至少2项评估。抑郁症状定义为CESD-10评分≥10分。连续时间多状态马尔可夫模型估计转移强度，概率和平均逗留时间。多变量模型提供了过渡特定风险比（hr）。结果：在45102例观察到的转变中，缓解强度超过进展强度（每年0.255 vs 0.154）。非抑郁症状组的平均逗留时间比抑郁症状组长（5.241年对3.238年）。5年时，缓解率为43.40%，进展率为26.20%。女性、低经济地位、多病、日常生活活动受限、短睡眠等因素的HRs分别为1.320、1.251、1.238、1.264、1.283，缓解率较低，HRs分别为0.816、0.859、0.854、0.830、0.855。跌倒（HR = 1.147）和吸烟（HR = 1.109）会增加病情进展。城市居住、较高的教育水平、参与活动和较高的生活满意度会降低病情进展，其hr分别为0.724、0.717、0.842和0.770，而城市居住、较高的生活满意度和每月至少饮酒一次会增加病情缓解，其hr分别为1.109、1.235和1.151。结论：中老年抑郁症状是双向的，具有潜在的可逆性。社会经济劣势、多发病和功能障碍形成了不利的转变，而可改变的行为和主观幸福感与改善的缓解有关。

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IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-01

引用次数: 0

IF 3.6 2区医学 Q2 GERIATRICS & GERONTOLOGY

Maturitas

Pub Date : 2026-01-01

引用次数: 0