Heart rate variability (HRV) is a non-invasive quantitative measure of cardiac autonomic nervous activity. Due to the increase of age and the decrease of estrogen level in perimenopausal and postmenopausal women, the cardiac autonomic nervous function is abnormal, increasing the risk of cardiovascular disease. Proper exercise can increase estrogen levels, improve cardiovascular health, regulate cardiac autonomic nervous activity, and reduce the risk of cardiovascular disease. Low-moderate intensity aerobic exercise, resistance exercise, aerobic combined resistance exercise and mind-body exercise have positive effects on HRV in perimenopausal and postmenopausal women. Therefore, summarizing the effects of different exercise modes on HRV in perimenopausal and postmenopausal women, as well as the mechanism of exercise training improvement on HRV, so as to adopt better exercise strategies to improve HRV of perimenopausal and postmenopausal women, and thus reduce the risk of cardiovascular diseases and improve the health level and quality of life of perimenopausal and postmenopausal women.
心率变异性(heart rate variability，HRV)可以无创定量评估心脏自主神经活动。围绝经期和绝经后妇女由于年龄的增加和体内雌激素水平的降低，导致其心脏自主神经功能异常，心血管疾病的患病风险增加。而适当的运动可以提高雌激素水平，改善心血管健康水平，调节心脏自主神经活动，降低心血管疾病的发生风险。中低强度的有氧运动、抗阻运动、有氧结合抗阻运动和身心运动可对围绝经期和绝经后妇女HRV产生积极影响。总结不同运动方式对围绝经期和绝经后妇女HRV的影响以及运动改善HRV的机制，可为采取更佳的运动策略以改善围绝经期和绝经后妇女HRV提供依据，进而降低心血管疾病的患病风险，提高围绝经期和绝经后妇女的健康水平和生活质量。.

This study aimed to identify hub genes and elucidate the molecular mechanisms underlying low bone mineral density (BMD) in perimenopausal women. R software was used to normalize the dataset and screen the gene set associated with BMD in perimenopausal women from the Gene Expression Omnibus database. Cytoscape software was used to identify 7 critical genes. Gene enrichment analysis and protein interaction was employed to further analyze the core genes, and the CIBERSORT deconvolution algorithm was used to perform immune infiltration analysis of 22 immune genes in the samples. Furthermore, an analysis of the immune correlations of 7 crucial genes was conducted. Subsequently, a receiver operating characteristic curve was constructed to assess the diagnostic efficacy of these essential genes. A total of 171 differentially expressed genes were identified that were primarily implicated in the signaling pathways associated with apoptosis. Seven crucial genes (CAMP, MMP8, HMOX1, CTNNB1, ELANE, AKT1, and CEACAM8) were effectively filtered. The predominant functions of these genes were enriched in specific granules. The pivotal genes displayed robust associations with activated dendritic cells. The developed risk model showed a remarkable level of precision, as evidenced by an area under the curve of 0.8407 and C-index of 0.854. The present study successfully identified 7 crucial genes that are significantly associated with low BMD in perimenopausal women. Consequently, this research offers a solid theoretical foundation for clinical risk prediction, drug sensitivity analysis, and the development of targeted drugs specifically tailored for addressing low BMD in perimenopausal women.

Objective: To explore the menopause status of patients with rheumatoid arthritis (RA) and clinical characteristics of perimenopausal RA patients. Methods: A cross-sectional study. Female RA patients were recruited retrospectively in the Sun Yat-Sen Memorial Hospital from August 2015 to August 2023. Clinical data were collected, including onset age, disease duration, RA disease activity indicators, functional assessment, and radiographic scores. According to menopausal status, the patients were categorized as pre-menopausal, perimenopausal and post-menopausal groups to explore their menopausal and clinical characteristics. Results: A total of 1 151 female patients were enrolled, with a mean age of (50.2±13.0) years. At enrollment, there were 470 (40.8%), 140 (12.2%) and 541 (47.0%) patients in pre-menopause, perimenopause and post-menopause status, respectively. The mean age of menopause was (49.0±4.2) years. Compared with pre-menopausal group, perimenopausal RA patients had higher disease activity indicators [clinical disease activity index (CDAI) 17 (6, 26) vs 10 (3, 19) ], higher levels of inflammation [erythrocyte sedimentation rate (ESR) 35 (21, 65) vs 26 (14, 44) mm/1h, C-reactive protein (CRP) 6.2 (3.2, 16.8) vs 3.3 (3.2, 13.6) mg/L], and a higher proportion of functional limitation [25.0%(35/140) vs 10.4%(49/470)] (all P<0.016 7); while there was no significant differences in disease activity[M(Q1, Q3)] [CDAI 17 (6, 26) vs 14 (6, 25)], levels of inflammation [ESR 35(21, 65) vs 42 (23, 72) mm/1h, CRP 6.2 (3.2, 16.8) vs 6.2 (3.3, 23.9) mg/L] and functional limitation [25.0%(35/140) vs 28.8%(156/541)] when compared with those in post-menopausal group (all P>0.016 7). In RA patients during the perimenopausal period, 49 cases (35.0%) developed RA during this period. Compared with patients with RA onset during reproductive age, patients with RA onset during the perimenopausal period had higher numbers of 28-joint tender joints [7 (2, 10) vs 4 (0, 8)], higher CDAI [20 (12, 29) vs 14 (4, 24)], and higher ESR [45 (25, 72) vs 32 (18, 56) mm/1h] (all P<0.05). Conclusion: Perimenopausal patients with RA have severe disease activity and functional limitation.
目的： 了解女性类风湿关节炎（RA）患者的绝经状态及围绝经期患者临床特征。 方法： 横断面研究。回顾性纳入2015年8月至2023年8月就诊于中山大学孙逸仙纪念医院的女性RA患者，收集其临床资料，包括发病年龄、病程、RA疾病活动、功能及放射学指标和绝经状态等。依绝经状态情况，将患者分为生育期、围绝经期和绝经后期组，分析绝经状态分布及比较3组的临床特征。 结果： 共纳入女性RA患者1 151例，年龄为（50.2±13.0）岁，入组时处于生育期患者470例（40.8%）、围绝经期140例（12.2%）和绝经后期541例（47.0%），绝经年龄为（49.0±4.2）岁。与生育期患者相比，围绝经期女性RA患者的疾病活动指标［临床疾病活动指数（CDAI）［M（Q1，Q3）］：17（6，26）比10（3，19）］、炎症水平［红细胞沉降率（ESR）：35（21，65）比26（14，44）mm/1h、C反应蛋白（CRP）：6.2（3.2，16.8）比3.3（3.2，13.6）mg/L］和功能受限的比例［25.0%（35/140）比10.4%（49/470）］均更高（均P<0.016 7）；而与绝经后期患者相比，RA疾病活动指标［CDAI：17（6，26）比14（6，25）分，ESR：35（21，65）比42（23，72）mm/1h、CRP：6.2（3.2，16.8）比6.2（3.3，23.9）mg/L］及功能受限比例［25.0%（35/140）比28.8%（156/541）］相当（均P>0.016 7）。围绝经期RA患者中，35.0%（49/140）患者RA为围绝经期发病，与生育期发病患者相比，围绝经期发病的RA患者28个压痛关节数［7（2，10）比4（0，8）个］、CDAI［20（12，29）比14（4，24）］及ESR水平［45（25，72）比32（18，56）mm/1h］均较高（均P<0.05）。 结论： 围绝经期女性RA患者的疾病活动和功能受限均较重。.

Background Perimenopause is associated with a decline in estrogen levels, leading to decreased bone mineral density (BMD) and altered bone metabolism, increasing the risk of osteoporosis. Tai Chi Rouli Ball, a traditional Chinese sport, is thought to have beneficial effects on physical health, but its impact on bone health in perimenopausal women is not well understood. Methods This study involved a randomized controlled trial with 52 perimenopausal women aged 45-55 years from community senior centers. Participants were divided into two groups: the Tai Chi Rouli Ball group and the control group. Baseline assessments of bone density, bone mineral content (BMC), and bone metabolism markers, including estrogen levels, were conducted. The Tai Chi Rouli Ball group underwent regular training for a specific period, while the control group did not receive any intervention. Post-experiment assessments were then compared to the baseline. Results Post-intervention, the Tai Chi Rouli Ball group showed a significant increase in spine bone density and BMC in various body parts, including the whole body, trunk/torso, and spine, compared to the control group. Bone metabolism indicators also improved, with increased levels of estrogen and a decrease in follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Calcium levels showed a significant increase, while other markers like alkaline phosphatase (ALP), phosphorus (P), and magnesium (Mg) had non-significant changes. Conclusions Tai Chi Rouli Ball exercise may positively influence bone health by improving bone density, BMC, and altering bone metabolism markers in perimenopausal women. These findings suggest that Tai Chi Rouli Ball could be a viable non-pharmacological approach to prevent osteoporosis in this demographic.

This cross-sectional study aimed to explore the knowledge, attitude and practice (KAP) toward sleep disorders and sleep hygiene among perimenopausal women, who were enrolled in Dezhou region of Shandong Province between July and September 2023. A total of 720 valid questionnaires were collected (mean age: 51.28 ± 4.32 years old), and 344 (47.78%) reported experiencing insomnia. The mean scores for knowledge, attitude, practice, and Dysfunctional Beliefs and Attitudes about Sleep (DBAS) were 15.73 ± 7.60 (possible range: 0-36), 29.35 ± 3.15 (possible range: 10-50), 28.54 ± 4.03 (possible range: 10-50), and 6.79 ± 1.90 (possible range: 0-10), respectively. Path analysis showed that knowledge had direct effects on attitude (β = 0.04, 95% CI 0.01-0.07, P = 0.001), and DBAS (β = 0.04, 95% CI 0.02-0.05, P < 0.001). Knowledge had direct effects (β = 0.11, 95% CI 0.08-0.15, P < 0.001) and indirect (β = 0.02, 95% CI 0.00-0.03, P = 0.002) effect on practice. Moreover, attitude also had a direct impact on practice (β = 0.34, 95% CI 0.25-0.43, P < 0.001). In conclusion, perimenopausal women exhibited insufficient knowledge, negative attitude, inactive practice toward sleep disorders and sleep hygiene, and unfavorable DBAS, emphasizing the need for targeted healthcare interventions.

BACKGROUND: Metabolic syndrome (MetS) is considered to be an important parameter of cardio-metabolic health and contributing to the development of atherosclerosis, type 2 diabetes. The incidence of MetS significantly increases in postmenopausal women, therefore, the perimenopausal period is considered a critical phase for prevention. We aimed to use four machine learning methods to predict whether perimenopausal women will develop MetS within 2 years.
METHODS: Women aged 45-55 years who underwent 2 consecutive years of physical examinations in Ninth Clinical College of Peking University between January 2021 and December 2022 were included. We extracted 26 features from physical examinations, and used backward selection method to select top 10 features with the largest area under the receiver operating characteristic curve (AUC). Extreme gradient boosting (XGBoost), Random forest (RF), Multilayer perceptron (MLP) and Logistic regression (LR) were used to establish the model. Those performance were measured by AUC, accuracy, precision, recall and F1 score. SHapley Additive exPlanation (SHAP) value was used to identify risk factors affecting perimenopausal MetS.
RESULTS: A total of 8700 women had physical examination records, and 2,254 women finally met the inclusion criteria. For predicting MetS events, RF and XGBoost had the highest AUC (0.96, 0.95, respectively). XGBoost has the highest F1 value (F1 = 0.77), followed by RF, LR and MLP. SHAP value suggested that the top 5 variables affecting MetS in this study were Waist circumference, Fasting blood glucose, High-density lipoprotein cholesterol, Triglycerides and Diastolic blood pressure, respectively.
CONCLUSIONS: We\'ve developed a targeted MetS risk prediction model for perimenopausal women, using health examination data. This model enables early identification of high MetS risk in this group, offering significant benefits for individual health management and wider socio-economic health initiatives.

UNASSIGNED: As women approach perimenopause, the incidence of Subjective Cognitive Decline (SCD) rises. This study aims to investigate the association between SCD and the severity of perimenopausal symptoms.
UNASSIGNED: Conducted at The Affiliated Hospital of Guizhou Medical University Menopause Clinic from November 2022 to June 2023. Participants, aged 40-55 years, were classified as perimenopausal using the STRAW + 10 criteria.
UNASSIGNED: SCD was assessed separately using the Chinese version of the SCD-Q9 scale and the SCD International Working Group (SCD-I) conceptual framework, while perimenopausal symptoms were evaluated with the Modified Kupperman Index (MKI). Linear relationships between MKI scores and SCD-Q9 scores were clarified using both univariate and multivariate linear regression analyses. Additionally, a multivariate Logistic regression analysis was conducted to examine the association between MKI scores and SCD classification based on SCD-I criteria.
UNASSIGNED: The primary outcomes were the Modified Kupperman Index scores, SCD-Q9 questionnaire scores, and the diagnosis of SCD based on SCD-I criteria.
UNASSIGNED: Among 101 participants, the average MKI score was 18.90 ± 9.74, and the average SCD-Q9 score was 4.57 ± 2.29. Both univariate and multivariate linear regressions demonstrated a positive correlation between these scores. A multivariate Logistic regression analysis, using MKI as the independent variable and SCD-I criteria classification as the dependent variable, revealed a significant positive association.
UNASSIGNED: A notable association exists between SCD and perimenopausal symptoms severity. This underscores the potential clinical importance of addressing perimenopausal symptoms to mitigate SCD risks in women. Further studies should focus on clarifying the causality between these factors.

BACKGROUND: An association between the menopause and depression is widely reported. This review aims to determine the global prevalence of depression in menopausal women (this includes women in perimenopause and postmenopause).
METHODS: PubMed, Web of Science, Embase, and PsycINFO databases were systematically searched from database inception until March 1, 2024. Studies with validated methods for assessing the prevalence of depression in perimenopausal and postmenopausal women were included. Two authors independently extracted relevant data. Random effects meta-analysis and Meta-regression analysis were performed using Stata software.
RESULTS: Total of 55 studies (76,817 participants) were included in the review. A random effects model was used to calculate pooled prevalence. The pooled depression prevalence in menopausal women was 35.6 % (95 % CI: 32.0-39.2 %), with 33.9 % (95 % CI: 27.8-40.0 %) in perimenopausal women, and 34.9 % (95 % CI: 30.7-39.1 %) in postmenopausal women. Subgroup analyses indicated that region, screening tool, study design, and setting moderated the prevalence of depression. Meta-regression indicated that smaller sample sizes and poorer study quality were significantly associated with a higher prevalence.
CONCLUSIONS: There was a high degree of heterogeneity across the included studies. Only articles published in English were included. There was significant publication bias in this meta-analysis. There is insufficient information about many risk factors of menopausal depression in current meta-analysis.
CONCLUSIONS: Depression is common among menopausal women worldwide. To reduce the negative impact of depression on health outcomes in menopausal women, regular screening and the availability of effective prevention and treatment measures should be made available for this population.

Tao-Hong-Si-Wu-Tang (THSWT), a traditional Chinese herbal remedy, is commonly utilized for the treatment of female perimenopausal depression through regulating menstruation, but the mechanism remains unknown. In this study, ICR mice were randomly divided into six groups: low, medium, and high dose of THSWT (0.5, 1.5, and 4.5 g/kg), soy isoflavone (250 mg/kg), ovariectomy group, and control group. All mice, except the control group, had ovaries removed and were exposed to hypoxic stimulation for 28 days to establish a perimenopausal depression mice model. The mice, having unrestricted access to food and water, were administered THSWT treatment for a duration of 14 days. The Western blotting and Enzyme linked immunosorbent assay kits were used to determine protein and hormone levels, respectively. Experimental results showed that THSWT reduced the immobility time of mice from 150.8 s to 104.9 s in the tail suspension test, and it decreased the immobility time of mice from 165.7 s to 119.0 s in the forced swimming test, outperforming the results obtained with soy isoflavones. In addition, THSWT upregulated the protein expression of follicle-stimulating hormone receptor and downregulated the protein expression of corticotropin-releasing hormone-receptor 1 in the hippocampus. Compared with the oophorectomized group, treatment with THSWT decreased the levels of corticosterone and adrenocorticotropic hormone in serum by 173.7 and 23.4 ng/mL, respectively. These findings showed that THSWT could stimulate the perimenopausal nerve tissue and regulate the level of serum hormones in mice. THSWT exhibited promising potential as a viable alternative drug for hormone treatment of perimenopause in clinical use.

The study aimed to investigate the relieving effect of QingYan Formula (QYF) in treating perimenopausal syndrome. A combination of metabonomic analysis and in vitro pharmacodynamic experiments was employed to achieve this objective.Over a period of 12 weeks, ovariectomized (OVX) rats were orally administered QYF\'s 70 % ethanol extract or estradiol valerate (EV). The results demonstrate that QYF restored the estrous cycle of ovariectomized rats and exhibited significant estrogenic activity, as indicated by reversal of uterine and vagina atrophy, improvement of serum estradiol level and decrease of serum luteinizing hormone(LH) level. Additionally, QYF administration effectively reduced high bone turnover and repaired trabecular microstructure damage. Metabonomic analysis of the OVX rats treated with QYF revealed the identification of 55 different metabolites in the serum, out of which 35 may be potential biomarkers. QYF could regulate the disturbed metabolic pathways including the Biosynthesis of unsaturated fatty acids, arachidonic acid metabolism, bile secretion, and steroid hormone biosynthesis. PI3KCA, SRC, and MAPK3 are potential therapeutic targets for QYF therapeutic effects. These findings support the efficacy of QYF in alleviating perimenopausal syndrome and regulating lipid metabolic disorders in OVX rats.