海南女性百岁老人性激素水平与全因死亡的关联分析

目的 探讨海南女性百岁老人性激素分布特征及与全因死亡的关系。方法 研究对象来自中国海南百岁老人队列研究,共717名符合条件的女性百岁老人纳入分析。采用Kaplan-Meier法绘制生存曲线,Cox比例风险回归模型分析性激素与生存时间的关系。结果 海南女性百岁老人雌二醇和孕酮的M(Q₁,Q₃)为32.60(18.40,58.70)pmol/L和0.62(0.32,1.01)nmol/L。存活组与死亡组雌二醇(pmol/L)和孕酮(nmol/L)分别为26.65 vs. 37.80、0.54 vs. 0.69,差异有统计学意义(P<0.05)。Cox比例风险回归模型分析结果显示,雌二醇和孕酮与死亡关联差异有统计学意义(P<0.05),雌二醇Q₄组的风险比(HR)值为1.58(95%CI:1.17~2.15),孕酮Q₃和Q₄组的HR值分别为1.53(95%CI:1.10~2.12)和1.63(95%CI:1.15~2.32)。亚组和交互分析结果显示,雌二醇与高血压、糖尿病和低HDL-C血症差异有统计学意义(P<0.05),且孕酮与糖尿病存在交互作用(P=0.016),睾酮与低HDL-C血症存在交互作用(P=0.034)。结论 海南女性百岁老人雌激素水平与较高的死亡风险有关,且与心血管代谢疾病(如糖尿病、高血压、脂代谢异常)的发病风险增加有关。

Association analysis between sex hormone levels and all-cause mortality in Hainan female centenarians

Objective To investigate the distribution characteristics of sex hormones and their relationship with all-cause mortality in Hainan female centenarians. Methods All the subjects were from China Hainan Centenarian Cohort Study. A total of 717 female centenarians were included in the final analysis. Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard regression was used to analyze the relationship between sex hormones and survival time. Results The M(Q₁, Q₃) of estradiol and progesterone among female centenarians was 32.60 (18.40, 58.70) pmol/L and 0.62 (0.32, 1.01) nmol/L. The estradiol (pmol/L) and progesterone (nmol/L) in the survival and death groups were 26.65 vs.37.80, 0.54 vs.0.69, respectively, with statistical differences (P<0.05). Cox multivariate analysis showed that estradiol and progesterone were significantly associated with death (P<0.05), the hazard ratio (HR) of estradiol Q₄ was 1.58 (95%CI:1.17-2.15), and the HR of progesterone Q₃ was 1.53 (95%CI:1.10-2.12), HR for Q₄was 1.63 (95%CI:1.15-2.32). Subgroup and cross-analysis showed that estradiol was statistically significant with hypertension, diabetes, and low high-density lipoprotein cholesterol (P<0.05), and progesterone interacted with diabetes (P=0.016), while testosterone interacted with low high-density lipoprotein cholesterol (P=0.034). Conclusion It is suggested that the estrogen levels of female centenarians in Hainan were associated with a higher mortality risk and an increased risk of cardiovascular metabolic disease (such as diabetes, hypertension, and abnormal lipid metabolism).