title: Association between duration of reproductive lifespan and Framingham risk score in postmenopausal women.
abstract: BACKGROUND
  The benefit of estrogen therapy in postmenopausal women is still uncertain. Based upon extensive observational data, it was believed that estrogen was cardioprotective. The relationship between the period of exposure to endogenous estrogens and the risk of cardiovascular disease (CVD) has not been studied in Korean women.
  
  
  OBJECTIVE
  To assess associations between reproductive lifespan and CVD by using the Framingham risk score (FRS) in postmenopausal Korean women.
  
  
  METHODS
  This cross-sectional, population-based study used data from the Korea National Health and Nutrition Examination Survey (KNHANES) for the five years 2008-2012,after adjustment for relevant variables using complex sample analysis and data weighting.
  
  
  METHODS
  Among 25,534 women, 1973 women were enrolled, after excluding those <20 or >80 years of age (n=6194), those with diabetes, CVD or cancer (n=491), those with unrecorded physical measurements (n=7335), those with menarche age ≤8 years or ≥20 years (n=6194), and premenopausal women (n=3347).
  
  
  RESULTS
  The FRS tended to show a significant negative correlation with the reproductive lifespan (p<0.001). In multiple linear regression analysis, a negative correlation was observed between the reproductive lifespan and FRS (adjusted relative risk [RR] for <28 reproductive years [shortest lifespan group] compared with 28-33 reproductive years [moderate lifespan group], 1.2, p<0.001 and adjusted RR for >33 reproductive years [longest lifespan group] compared with 28-33 reproductive years [moderate lifespan group], -0.42, p=0.011).
  
  
  CONCLUSIONS
  A longer reproductive lifespan is associated with a lower estimated risk of CVD in the next 10 years in postmenopausal women. This result suggests that estrogen has a long-term protective effect against CVD.
authors.affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Mu Yul
authors.initials: MY
authors.lastname: Sim
authors.affiliation: Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: sbpark@ajou.ac.kr.
authors.forename: Sat Byul
authors.initials: SB
authors.lastname: Park
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004967:Estrogens; D005260:Female; D006801:Humans; D008875:Middle Aged; D009749:Nutrition Surveys; D017698:Postmenopause; D012098:Reproduction / Q000502:physiology*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D013997:Time Factors
chemical_list: D004967:Estrogens
keywords: Cardiovascular disease; Framingham risk score; Menopause; Reproductive lifespan