Asymptomatic Postmenopausal Women Research Articles

Evaluation of the diagnostic role of transvaginal ultrasound measurements of endometrial thickness to detect endometrial malignancy in asymptomatic postmenopausal women.

To assess the diagnostic accuracy of endometrial thickness measurements of transvaginal ultrasound (TVUS) in asymptomatic postmenopausal women in the detection of endometrial malignancy. A retrospective cohort study in a university hospital was undertaken with 276 consecutive asymptomatic postmenopausal women undergoing dilatation and curettage (D&C) and hysteroscopy for an incidental finding of thickened endometrium (≥4mm) between 2003 and 2012. Different endometrial thickness cutoff values were tested on the basis of a pathologic report with carcinoma conditions (endometrial hyperplasia with atypia and endometrial carcinoma). The mean age of patients was 59.8±9.0years. The mean duration of menopause was 11.2±8.9years. The final pathology diagnoses included 107 (38.8%) patients with polyps, 42 (15.2%) with atrophic endometrium, 39 (14.1%) with estrogen exposure, and 19 (6.9%) with normal endometrium. With regard to carcinoma conditions, nine patients (3.3%) had endometrial hyperplasia with atypia and eight patients (2.9%) had endometrial carcinoma. The area under the ROC curve was 0.52 (95% CI 0.44-0.57), which indicated a poor accuracy of endometrial thickness of TVUS for carcinoma conditions. Routine use of endometrial thickness measurement with TVUS does not seem to be an effective diagnostic tool for endometrial cancer because it has a low diagnostic performance in asymptomatic postmenopausal women. Further prospective studies are required to assess the endometrial thickness measurement with TVUS as a screening method in these women.

Relationship Between Hysteroscopic and Hystological Findings in Postmenopausal Asymptomatic Women With Thickened Endometrium

Relationship Between Hysteroscopic and Hystological Findings in Postmenopausal Asymptomatic Women With Thickened Endometrium

The utility of endometrial thickness measurement in asymptomatic postmenopausal women with endometrial fluid

The aim of this study was to assess the clinical usefulness of sonographic endometrium thickness measurement in asymptomatic postmenopausal women with endometrial fluid collection. Fifty-two asymptomatic postmenopausal women with endometrial fluid, who underwent endometrial sampling were evaluated. Histopathological findings revealed that 25 (48.1%) women had insufficient tissue, 20 (38.4%) had atrophic endometrium and 7 (13.5%) had endometrial polyps. No case of malignancy was found. There was no statistically significant difference between the various histopathological categories (insufficient tissue, atrophic endometrium and polyp) with regard to the mean single-layer endometrial thickness (1.54 ± 0.87, 2.04 ± 1.76 and 1.79 ± 0.69 mm, respectively, p = 0.436). Out of 44 patients with endometrial thickness of less than 3 mm, 38 (86.4%) had atrophic changes or insufficient tissue and 6 (13.6%) had endometrial polyps. In conclusion, if the endometrial thickness is 3 mm or less, endometrial sampling is not necessary in asymptomatic postmenopausal women with endometrial fluid.

Do postmenopausal women with thickened endometrium on trans-vaginal ultrasound in the absence of vaginal bleeding need hysteroscopic assessment? A Pilot Study

We aimed to determine the incidence of endometrial cancer in a cohort of postmenopausal women with thickened endometrium but no bleeding referred for hysteroscopy and determine the risk estimate of cancer using a cut-off of > 11 mm. This retrospective study of asymptomatic postmenopausal women with thickened endometrium on trans-vaginal scan referred for hysteroscopy was performed using data from 2008 to 2010. In total 63 women were identified. 2 cases of endometrial cancer were identified with an incidence of 3.17%. 22 cases had endometrial thickness (ET) > 11 mm of which 2 were malignant giving a risk estimate for endometrial cancer of 9.1%. 61 women had benign pathology, 40.98% had atrophic endometrium and 59.02% had benign polyp. In conclusion, the incidence of endometrial cancer in postmenopausal women with thickened endometrium on transvaginal scan without vaginal bleeding is low and ET of 11 mm or more seems realistic to use as a cut-off for referral for hysteroscopy.

Effects of Estradiol Withdrawal on Mood in Women With Past Perimenopausal Depression: A Randomized Clinical Trial.

Perimenopause is accompanied by an increased risk of new and recurrent depression. The coincidence of declining ovarian function with the onset of depression led to the inference that "withdrawal" from physiologic estradiol levels underpinned depression in perimenopause. To our knowledge, this is the first controlled systematic study to directly test the estrogen withdrawal theory of perimenopausal depression (PMD). To examine the role of estradiol withdrawal in PMD. Initial open-label treatment with estradiol followed by randomized, double-blind, placebo-controlled, parallel-design evaluation of continued estradiol treatment was evaluated at an outpatient research facility at the National Institutes of Health Clinical Center. An intent-to-treat analysis was performed between October 2003 and July 2012. Participants included asymptomatic postmenopausal women with past PMD responsive to hormone therapy (n = 26) and asymptomatic postmenopausal women with no history of depression (n = 30) matched for age, body mass index, and reproductive status who served as controls. Data were analyzed between November 2012 and October 2013 by repeated-measures analysis of variance. After 3 weeks of open-label administration of transdermal estradiol (100 µg/d), participants were randomized to a parallel design to receive either estradiol (100 µg/d; 27 participants) or matched placebo skin patches (29 participants) for 3 additional weeks under double-blind conditions. Center for Epidemiologic Studies-Depression Scale and 17-item Hamilton Depression Rating Scale (completed by raters blind to diagnosis and randomization status), self-administered visual analog symptom ratings, and blood hormone levels obtained at weekly clinic visits. None of the women reported depressive symptoms during open-label use of estradiol. Women with past PMD who were crossed over from estradiol to placebo experienced a significant increase in depression symptom severity demonstrated using the Center for Epidemiologic Studies-Depression Scale and 17-item Hamilton Depression Rating Scale, with mean (SD) scores increasing from estradiol (ie, 2.4 [2.0] and 3.0 [2.5]) to placebo (8.8 [4.9] and 6.6 [4.5], respectively [P = .0004 for both]). Women with past PMD who continued estradiol therapy and all women in the control group remained asymptomatic. Women in both groups had similar hot-flush severity and plasma estradiol levels during use of placebo. In women with past PMD that was previously responsive to hormone therapy, the recurrence of depressive symptoms during blinded hormone withdrawal suggests that normal changes in ovarian estradiol secretion can trigger an abnormal behavioral state in these susceptible women. Women with a history of PMD should be alert to the risk of recurrent depression when discontinuing hormone therapy. clinicaltrials.gov Identifier: NCT00060736.

The clinical significance of endometrial fluid collection in asymptomatic postmenopausal women

Objective This study assessed the clinical significance of endometrial fluid collection (EFC) in asymptomatic postmenopausal women.Materials and methods A total of 564 postmenopausal females were enrolled into this retrospective study, of whom 141, with EFC, comprised the study group; the remaining 423 postmenopausal women (the three consecutive patients) who had been admitted to the menopause outpatient clinic for their routine annual check formed the control group. Data, including age, gravidity, parity, body mass index, hypertension, diabetes mellitus, menopause duration, endometrial thickness and histopathological endometrium results, were compared between groups using the SPSS for Windows software package (version 15.0; SPSS Inc., Chicago, IL, USA).Results There were no significant group differences in gravidity, parity, body mass index, rates of hypertension and diabetes mellitus, endometrial thickness or histopathological endometrium results. However, there were group differences in age (62.0 ± 7.6 vs. 57.2 ± 8.9 years, p < 0.001) and menopause duration (13.4 ± 7.8 vs. 7.9 ± 5.4 years, p < 0.001).Conclusion The results indicate that EFC in asymptomatic postmenopausal women is a benign condition, influenced by older age and commensurately longer menopause duration due to a lack of hormonal stimulation. The presence of EFC by itself does not affect the decision to provide further evaluation; that is determined by the presence of confirmed risk factors (e.g. thickened endometrial stripe). However, further studies are needed to assess any long-term prognostic impact of this finding.

Miniature hygrometric hot flush recorder as an objective indicator of hot flushes: a validation study.

Hot flushes are a very common symptom of menopause for which many women seek medical help. Accurate assessment of clinical severity and of the impact of treatment is limited by a lack of methods for objective hot flush recording. The aim of the current study is to test the diagnostic value of a miniature hygrometric hot flush recorder (HFR). The HFR was tested in 50 women with severe postmenopausal hot flushes. Results were compared with recordings in 27 asymptomatic postmenopausal women, 12 premenopausal women, and 12 age-matched healthy men. The number of HFR events was compared with the number of diary-reported hot flushes. Healthy young women and men had a mean (SEM) of 17.3 (1.3) HFR events/day. Asymptomatic postmenopausal women had 13.6 (1.4) HFR events/day, whereas symptomatic postmenopausal women had 21.0 (1.0) HFR events/day (P < 0.001). The number of HFR events in symptomatic women was significantly higher than the number of diary-reported hot flushes (mean [SEM], 13.8 [0.6] hot flushes/d) (P < 0.001). HFR sensitivity to diary-reported hot flushes was 55.1%, with 61.4% specificity. The miniature hygrometric HFR has limited sensitivity and specificity. It detects sweating in general but does not differentiate between natural sweating and hot flush-related sweating. However, it may become useful as a tool for improving the data quality of diary-reported hot flushes.

Clinicopathologic significance of Papanicolaou smear study of postmenopausal women in a rural tertiary care center

Background: Cervical cancer is a preventable disease in the vast majority of women. Papanicolaou (Pap) smear is still the most effective screening tool available for preventing cervical cancer. Therefore, it is important to investigate the significance of screening in older women. Objective: To study the distribution of cervical cancer among postmenopausal women and to determine the significance of cervical cancer screening in symptomatic and asymptomatic postmenopausal women. Materials and Methods: A total of 590 Pap smears were obtained from postmenopausal women between September 2012 and March 2013. Prefixed conventional cervical smears were stained with Pap stain. The cytology results were reported using the Bethesda system terminology. Results: Among the 590 postmenopausal women studied, 38.9% of asymptomatic postmenopausal women had clinically significant lesion whereas only 33.1% of symptomatic women had clinically significant lesion. There was low-grade squamous intraepithelial lesion at percentage of 17.5. Asymptomatic and symptomatic were 11.5% and 6.5%, respectively. High-grade squamous intraepithelial lesion was 4.5%. Asymptomatic and symptomatic were 7.5% and 2.85%, respectively. Atypical squamous cells of undetermined significance were seen in 8.85%. Asymptomatic and symptomatic were 4.25% and 4.6% respectively. Atypical glandular cells of undetermined significance were 1.7%. Only 3.2% of significant lesion was squamous cell carcinoma, and all were symptomatic. Conclusion: Postmenopausal women especially from the rural area and low socioeconomic strata suffered disproportionately from precancerous and cancerous lesions of the cervix. To reduce this burden, it's mandatory to motivate and screen asymptomatic older women.

Effect of Body Mass Index on Endometrial Thickness in Asymptomatic Postmenopausal Women

Effect of Body Mass Index on Endometrial Thickness in Asymptomatic Postmenopausal Women

Relation of serum 25 hydroxyvitamin D levels to bone mineral density in southern Chinese postmenopausal women: A preliminary study.

Background & objectives:Vitamin D insufficiency is prevalent in postmenopausal women and has been related to low bone mineral density (BMD). However, controversial results have been reported for the relationship between serum 25-hydroxyvitamin D [25(OH)D] levels and BMD. This study was done to investigate whether serum 25(OH)D levels were associated with BMD in postmenopausal women living in Guangzhou in southern China.Methods:This cross-sectional study involved 119 asymptomatic postmenopausal women, aged 48-85 yr, who were consecutively selected from Guangzhou city. BMD was measured at the lumbar spine and femoral neck. The correlation between serum 25(OH)D levels and BMD wes investigated.Results:With increasing serum 25(OH)D levels categorized as <20, 20-30, and ≥30ng/ml, the PTH levels decreased gradually (P=0.031). Bivariate correlation analyses showed an inverse relationship between serum 25(OH)D and PTH levels after controlling for age and BMI (r=-0.209, P=0.023). Although subjects with vitamin D<30 ng/ml had significantly lower BMD, age- and BMI-adjusted serum 25(OH)D was weakly correlated with BMD at femoral neck (r=0.185, P=0.045), and not at lumbar spine (r=0.172, P=0 0.063). In multiple regression analyses, serum 25(OH)D was a predictor for BMD at femoral neck (R2=0.424). However, serum β-CTX was a determinant for BMD at lumbar spine (R2=0.361).Interpretation & conclusions: Serum 25(OH)D levels showed a positive correlation with BMD at femoral neck and serum β-CTX levels were inversely correlated with BMD at lumbar spine in postmenopausal women. Further studies are needed to elucidate the clinical impact of these findings.

Ovarian simple cysts in asymptomatic postmenopausal women detected at transvaginal ultrasound: A review of literature

Ovarian simple cysts in asymptomatic postmenopausal women detected at transvaginal ultrasound: A review of literature

Physical function decline and degradation of postural sway dynamics in asymptomatic sedentary postmenopausal women.

Postural control is an important aspect of physical functioning. To determine whether postural sway complexity could discriminate asymptomatic sedentary postmenopausal women with normal or subnormal physical function from those with lower physical function. Cross-sectional study. Department of Geriatrics, University Hospital of Montpellier. 126 community-dwelling women aged 55 to 76 recruited though public meetings aimed at promoting physical activity in postmenopausal women. Women were asked to stand still on a force platform, either with eyes open (EO) or eyes closed (EC). Physical function was estimated using the Six-Minute Walking Distance (6MWD) test, expressed as a percentage of the predicted 6MWD (%-pred 6MWD) based on age, gender, body height, and weight. In addition to traditional stabilometric measures, dynamical measures (percentage of determinism of recurrence quantification analysis [DETRQA], sample entropy [SampEn] and complexity index of multiscale entropy [CIMSE]) were used to quantify the complexity of center of pressure (COP) time series (DETRQA: predictability, SampEn: regularity, CIMSE: multiscale regularity). None of the traditional stabilometric measures differentiated women with lower (%-pred 6MWD ≤ 85.5%) from those with subnormal or normal (%-pred 6MWD > 85.5%) physical function. Conversely, women with lower physical function showed lower SampEn values in the AP direction in both EO and EC conditions, as well as lower SampEn and higher DETRQA values in the ML direction in EC condition. No significant difference in the CIMSE values was found between the two groups. Lower physical function was found to be associated with lower postural sway complexity (higher regularity and predictability) in asymptomatic sedentary postmenopausal women, especially in the absence of vision. Future work is needed to determine whether a decrease in postural sway complexity could predict future decline in physical function in these women.

Evaluation of endometrial thickness in postmenopausal women by using 3.0-T MRI

Background: The accepted threshold for normal endometrial thickness is 5 mm; lesions with endometrial thickness &lt; 5 mm are considered benign, whilst those &gt; 5 mm areconsidered malignant. However, endometrium ≥ 5 mm on transvaginal ultrasonography inpostmenopausal woman is considered as asymptomatic endometrial thickening. However, recent studies suggest that asymptomatic endometrial thickness of even 8 mm – 11 mm in postmenopausal women may be normal.Objectives: The present study investigated the normal endometrial thickness range in 297 asymptomatic postmenopausal women using 3.0-T magnetic resonance imaging (MRI) T2-weighted sagittal images measured retrospectively by a single radiologist.Method: The data were classified according to patient age and postmenopausal duration, and the medical records and follow-up MR images were reviewed to assess the clinical outcome.Results: The mean endometrial thickness was 2.4 ± 0.1 mm (range: 0.1–11.6). The endometriumin 21 of 297 subjects was ≥ 5 mm thick. Follow-up MR images were obtained in 17 of these 21 women, and their endometrial thickness was found to have decreased in all of them. To date,none of the subjects has been diagnosed with endometrial cancer.Conclusion: Although 5 mm is considered the conservative threshold of normal endometrial thickness on MRI of postmenopausal women, this figure should not, to avoid excessive false-positive diagnoses, be assumed as an indication of malignancy.

Endometrial pathology in the postmenopausal woman – an evidence based approach to management

Key content This article outlines how to identify the symptoms and signs associated with endometrial pathology and how these correlate with the final diagnosis. The evidence for and against intervention in asymptomatic women with a coincidental finding of endometrial pathology is discussed. This article looks at how best to investigate symptomatic women on hormone replacement therapy (HRT) and selective estrogen receptor modulators (SERMs). Screening for endometrial pathology is discussed. Learning objectives To be able to identify risk factors associated with postmenopausal endometrial pathology, as well as symptoms and signs. To learn about the models of care for different endometrial pathology. To understand the contentious issues and the risk‐benefit profile of different strategies for the management of asymptomatic women. Ethical issues Does an incidental finding of a thick endometrium in asymptomatic postmenopausal women warrant further investigation? Should asymptomatic women receiving HRT or SERMs be routinely screened and investigated?

The discriminative ability of FRAX, the WHO algorithm, to identify women with prevalent asymptomatic vertebral fractures: a cross-sectional study.

BackgroundA Moroccan model for the FRAX tool to determine the absolute risk of osteoporotic fracture at 10 years has been established recently. The study aimed to assess the discriminative capacity of FRAX in identifying women with prevalent asymptomatic vertebral fractures (VFs).MethodsWe enrolled in this cross-sectional study 908 post-menopausal women with a mean age of 60.9 years ±7.7 (50 to 91) with no prior known diagnosis of osteoporosis. Subjects were recruited from asymptomatic women selected from the general population. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a GE Healthcare Lunar Prodigy densitometer. VFs were defined using a combination of Genantsemiquantitative (SQ) approach and morphometry. We calculated the absolute risk of major fracture and hip fracture with and without bone mineral density (BMD)using the FRAX website.The overall discriminative value of the different risk scores was assessed by calculating the areas under the ROC curve (AUC).ResultsVFA images showed that 179 of the participants (19.7%) had at least one grade 2/3 VF. The group of women with VFs had a statistically significant higher FRAX scores for major and hip fractures with and without BMD, and lower weight, height, and lumbar spine and hip BMD and T-scores than those without a VFA-identified VF. The AUC ROC of FRAX for major fracture without BMD was 0.757 (CI 95%; 0.718-0.797) and 0.736 (CI 95%; 0.695-0.777) with BMD, being 0.756 (CI 95%; 0.716-0.796) and 0.747 (CI 95%; 0.709-0.785), respectively for FRAX hip fracture without and with BMD. The AUC ROC of lumbar spine T-score and femoral neck T-score were 0.660 (CI 95%; 0.611-0.708) and 0.707 (CI 95%; 0.664-0.751) respectively.ConclusionIn asymptomatic post-menopausal women, the FRAX risk for major fracture without BMD had a better discriminative capacity in identifying the women with prevalent VFs than lumbar spine and femoral neck T-scores suggesting its usefulness in identifying women in whom VFA could be indicated.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-365) contains supplementary material, which is available to authorized users.

Clinical factors and malignancy in endometrial polyps. Analysis of 1027 cases

Study objectiveTo assess the prevalence of polyps carrying a malignancy and match association between clinical factors and oncologic progression. Study designA retrospective study (Canadian Task Force classification II-3) at a university hospital in Rome, Italy. We retrospectively analyzed data from 1027 women consecutively treated for endometrial polyps at our center in the period 2002–2011. The association of malignancy with hormonal status, tamoxifen, hypertension, symptoms, diabetes mellitus, obesity, and hormonal replacement therapy in pre- and post-menopausal women was assessed. ResultsMean age was 45.8±10.8 years. Benign polyps accounted for 95.8% of the total, pre-malignant for 2.67%, malignant for 1.54%. Our data showed that post-menopausal and older women (>60y) with endometrial polyps have a higher risk of developing a related endometrial cancer (OR: 3.05, 95% CI [1.54, 6.19], p<0.001 and OR: 2.8, 95% CI [1.38, 5.56], p≤0.003. Also we observed that women with AUB in the post-menopausal period displayed a risk of malignancy (OR: 31.1, 95% CI [10.3,111], p value <0.001). ConclusionSpecial attention should be drawn to symptomatic post-menopausal patients that appear to be at higher risk of malignancy. Symptomatic pre-menopausal women and asymptomatic post-menopausal women with polyps may be a group with intermediate-risk. These patients should undergo an individualized management plan, balancing both risks and benefits of surgical intervention after discussion with the patient.

Hysteroscopic Findings in Asymptomatic Postmenopausal Women with Sonographically Thickened Endometrium: Comparison with the Histopathologic Diagnosis after Hysterectomy

To define the diagnostic accuracy of office hysteroscopy in asymptomatic postmenopausal women with sonographically thickened endometrium, comparing hysteroscopic findings and pathologic diagnosis after hysterectomy.

Risks and benefits of hysteroscopy and endometrial sampling as a standard procedure for assessing serendipitous findings of endometrial thickening in postmenopausal women.

A retrospective study was undertaken of 35 asymptomatic postmenopausal women undergoing hysteroscopy, dilatation and curettage (H D&C) for an incidental finding of thickened endometrium to assess the rate of significant pathological findings, cost per finding and complication rate of any procedures performed. This study found one case of endometrial adenocarcinoma (1/35; 3%) at an estimated cost per significant finding of $507,116 with an estimated 11.6 complication events per finding.

Diagnostic accuracy of endometrial thickness for the detection of intra-uterine pathologies and appropriateness of performed hysteroscopies among asymptomatic postmenopausal women

ObjectiveTo measure the diagnostic accuracy of endometrial thickness for the detection of intra-uterine pathologies among asymptomatic postmenopausal women, and to test the diagnostic accuracy and appropriateness of performed hysteroscopies. Study designProspective study of 268 asymptomatic postmenopausal women with endometrial thickness ≥4mm referred to diagnostic hysteroscopy. The diagnostic accuracy of various endometrial thickness cut-off values was tested. Histological and hysteroscopic results were compared to measure the diagnostic accuracy of outpatient hysteroscopies. ResultsNo endometrial thickness cut-off values had optimal diagnostic accuracy [positive likelihood ratio (LR+) >10 and negative likelihood ratio (LR−) <0.1]. The best endometrial thickness cut-off value for the detection of all intra-uterine pathologies was ≥8mm (LR+ 10.05 and LR− 0.22). An endometrial thickness cut-off value ≥10mm did not miss any cases of endometrial cancer. The success rate of diagnostic hysteroscopy was 89%, but 97% of these revealed a benign intra-uterine pathology. The diagnostic accuracy of hysteroscopy was optimal for all intra-uterine pathologies, except endometrial hyperplasia (LR− 0.52). ConclusionUsing an endometrial thickness cut-off value ≥4mm, only 3% of performed hysteroscopies were useful for the detection of pre-malignant or malignant lesions. Despite the finding that endometrial thickness did not show optimal diagnostic accuracy, using the best cut-off value (≥8mm) may be helpful to decrease the number of false-positive results. No cases of endometrial cancer were diagnosed in asymptomatic postmenopausal women with endometrial thickness <10mm.

Abstract P194: Fruit and Vegetable Slows Subclinical Atherosclerosis in Chinese Women

Objectives: This study aimed to investigate lifestyle factors, particularly fruit and vegetable intake in the protection against the progression of SA in early postmenopausal Chinese women. Methods: This is a community-based 5-year followup study on a cohort of 518 women recruited through random telephone dialing. All were aged 50-64y and within 10 years menopause. Lifestyle and dietary variables based on validated and structured questionnaires, clinical assessments and fasting blood samples were obtained at baseline (T 1 ) and 5-year followup (T 2 ). A 12.5-MHz linear probe of the HDI 5000 ultrasound scanner was used for measuring intima-media thickness (IMT) at the near and far walls of three 10-mm segments: distal common carotid, bifurcation, proximal internal carotid of both the left and right carotid arteries. The final IMT was the averages of maximum IMT free of atherosclerotic plaques measured at each of the 12 segments. Atherosclerotic plaques defined as a focal wall thickening of at least 1.5mm were also identified along the defined segments. Plaque was graded as: grade 0, no observable plaque; 1, one small plaque &lt;30% of vessel diameter; 2, one medium plaque between 30-50% of vessel diameter or multiple small plaques; 3, one large plaque &gt;50% vessel diameter or multiple plaques with at least one medium plaque. Repeated measurements of IMT and plaque were also obtained at T 2 . Plaque progression was computed by subtracting the plaque index at T 1 from the plaque index at T 2 . The within-sonographer intraclass correlations were 0.83-0.88 for IMT and 0.99 for plaque index, and between sonographer correlations were 0.81-0.88 for IMT, and 0.88- 0.99 for plaque index. Results: The five-year followup study of asymptomatic Chinese early postmenopausal women (mean age 61.5 years at T 2 ) has revealed a progression of IMT of 2.1 % (standard deviation =1.7) or a progression rate of 0.015 mm/year (standard deviation = 0.013). 25 % were found to have plaque progression (change of plaque index score of ≧1). Besides the traditional CVD risk factors (age, higher values of total cholesterol, systolic and diastolic blood pressure, LDL-cholesterol and triglyceride), multiple regression analysis showed that higher fruit and vegetable intake was a significant (p=0.001) and independent predictor of lower IMT at T 2 . Analysis of the followup data showed that maintenance of high intake of fruit and vegetable (&gt;median) at both T 1 and T 2 was associated with lower IMT at T 2 , even adjusted for the other significant predictors. Similar relationship with plaque progression was also observed. Conclusion: This population-based cohort study of Chinese asymptomatic midlife women has identified maintenance of high fruit and vegetable intake tended to reduce the risk of SA.