Middle-aged Korean Women Research Articles

The effect of menopause on cardiovascular risk factors according to body mass index in middle-aged Korean women.

Menopausal status and obesity are associated with an increased risk for cardiovascular diseases. However, there are few studies on the effect of menopause on cardiovascular risk factors according to the degree of obesity during the menopausal transition. We aimed to evaluate the effect of menopause on cardiovascular risk factors according to body mass index (BMI) in middle-aged Korean women. We analyzed 361 postmenopausal women and 758 premenopausal women (age: 45-55 years) without diabetes mellitus, hypertension, or dyslipidemia, using a cohort database released by the Korean National Health and Nutrition Examination Survey 2016-2018. Subjects were divided into two groups based on BMI. Women who underwent a hysterectomy or were pregnant were excluded from this study. Differences between groups adjusted for age and BMI were assessed. Postmenopausal women (52 ± 2 years) were older than premenopausal women (48 ± 2 years), and BMI did not differ between the two groups (22.8 ± 2.9 vs. 23.0 ± 3.1 kg/m2). After adjustment for age and BMI in total and non-obese subjects (not obese subjects), postmenopausal women exhibited higher hemoglobin A1c and total cholesterol levels than premenopausal women. Subgroup analysis for 138 postmenopausal and 138 age- and BMI-matched premenopausal women showed that postmenopausal women had higher total cholesterol levels than premenopausal women with marginal significance (201 ± 25 vs. 196 ± 27 mg/dL). Menopausal status was associated with increased glucose and cholesterol levels independent of age and BMI in middle-aged Korean women. Menopausal status showed a significant relationship with increased total cholesterol levels even after adjusting for age and BMI in non-obese women but not obese women. Therefore, intensive monitoring and treating of lipid status is necessary to prevent cardiovascular events during the menopausal transition, especially in non-obese subjects.

The Relationship between Dietary Na/K Ratio and Bone Mineral Density in Korean Middle-Aged Women.

Dietary Na+ or Na+/K+ ratio has been reported to be associated with bone mineral density (BMD). However, this remains unclear, and only a few studies have been reported on the Korean population. Therefore, this study aimed to determine the association between dietary Na+, K+, and Na+/K+ ratios and BMD in middle-aged Korean women. This study used data from the Korea National Health and Nutrition Examination Survey 2008-2011. A total of 3,690 women aged >50 years were included. Study participants were classified into quartiles (lowest quartile Q1-highest quartile Q4) according to dietary Na+, K+, and Na+/K+ ratio, and we examined the association of these parameters with BMD. Total femur and lumbar spine BMD were measured using dual-energy X-ray absorptiometry. Multiple linear regression analyses were performed using IBM SPSS ver. 19.0. The mean age was 62 years, and a significant negative trend in the β-coefficient regarding dietary Na+ was only observed in the total femur BMD. However, the total femur and lumbar spine BMD decreased from Q1 to Q4 regarding the dietary Na+/K+ ratio (P-value for trend: 0.044 for total femur BMD and 0.002 for lumbar spine BMD). A significant negative trend in the β-coefficient for both total femur and lumbar spine BMD was observed regarding the Na+/K+ ratio. Therefore, based on the results of this study, a higher dietary Na+/K+ ratio may be associated with a lower BMD.

Correlation of Sarcopenic Obesity on Various Cardiometabolic Risk Factors and Fracture Risk in Mid-Aged Korean Women.

This study aimed to investigate the correlation of sarcopenic obesity with various cardiometabolic risk factors and fracture risk in middle-aged Korean women. In this cross-sectional study, the medical records of 1,775 women who had visited Pusan National University Hospital for routine health screenings from 2010 to 2016 were reviewed. The patients were divided into four groups as follows: group 1, nonsarcopenic, nonobese (NS-NO); group 2, nonsarcopenic, obese (NS-O); group 3, sarcopenic, nonobese (S-NO); and group 4, sarcopenic, obese (S-O). Each patient was assessed based on self-reported questionnaires and individual interviews with a healthcare provider. The Fracture Risk Assessment Tool (FRAX) was used to assess bone fracture risk. Postmenopausal women accounted for 68.5% of the total patient population. The proportion of each group was as follows: NS-NO, 71.2%; NS-O, 17.9%; S-NO, 10.2%; and S-O, 0.7%. Statistical analysis of various parameters associated with metabolic and cardiovascular risks revealed that the S-O group had more patients with hypertension, diabetes, osteopenia, and metabolic syndrome. The FRAX scores were significantly higher in the S-O group than in other groups. Middle-aged women with obesity and reduced muscle mass, known as sarcopenic obesity, are at increased risk of hypertension, diabetes, and metabolic syndrome. Furthermore, sarcopenic obesity, individual cardiometabolic risks, and menopause can increase the bone fracture risk.

Substantial Lipid Increases During Menopausal Transition in Korean Middle-Aged Women.

Adverse lipid profiles are observed in postmenopausal women. However, there is insufficient evidence of the association between lipids and reproductive aging in Korean women. We aimed to characterize lipid changes with respect to timing relative to menopause in Korean middle-aged women. This study included 1,436 premenopausal women who had a natural menopause during the follow-up period (median = 15.76 years) from the Korean Genome and Epidemiology Study (KoGES) Ansan and Anseong cohort. Lipid levels were measured every 2 years, and the magnitudes of annual lipid changes and differences in the changes by premenopausal body mass index were estimated using piecewise linear mixed-effects models. All lipid levels increased greatly from 3 or 5 years before menopause to 1 year after menopause in all women, regardless of their premenopausal body mass index. During the period, high-density lipoprotein cholesterol (HDL-C) levels increased at 0.42 mg/dL per year (95% confidence interval [CI], 0.29 to 0.55 mg/dL). Nevertheless, non-HDL-C levels simultaneously increased at 3.42 mg/dL per year (95% CI, 3.11 to 3.72 mg/dL), and an annual change in the non-HDL-C to HDL-C ratio was 0.05 (95% CI, 0.04 to 0.06). One year after menopause, changes in all lipid parameters significantly slowed down, except for the non-HDL-C to HDL-C ratio (P < 0.001 for all). The ratio continued to increase until 3 years after menopause, but thereafter, the change leveled off. Women experienced remarkable increases in lipid levels during menopausal transition, highlighting the need for early intervention strategies for cardiovascular disease prevention in women.

"Hwabyeong", a Korean Cultural Syndrome

Hwabyeong is known as a Korean cultural-bound syndrome which is situated at the intersection between depression and anger syndrome. Translated as “anger illness” or “fire illness”, hwabyeong is a mental illness resulted from repressed feelings, which has a specific somatization in middle-aged Korean women: lump in throat or chest, feeling of suffocation, palpitations, heat sensation, burning feeling in the stomach, insomnia etc. While this syndrome is often stressed as a clinical study case, hwabyeong can also be found in Korean literature, proving the power it holds within the society. Two such cases from Korean contemporary literature are The Vegetarian, by Han Kang, and Kim Jiyeong, born 1982, by Cho Nam-joo. Despite the fact that no one mentions hwabyeong, the main characters show clear symptoms of the disorder. They also match the pattern of those who suffer from this disease. At first glance, someone might say they are gone mad, but looking more closely at their background, their symptoms and behavior, they are no different from many other Korean women. Yeong-hye and Kim Jiyeong are two women from South Korea who experience body rebellion because of society’s failure to let them express as individuals with personal needs, ambitions and feelings.

ICT usage and health behavior among Korean middle-aged men and women: The mediating role of self-efficacy

ICT usage and health behavior among Korean middle-aged men and women: The mediating role of self-efficacy

Mediating Effect of Self-Cognitive Oral Health Status on the Effect of Obstructive Sleep Apnea Risk Factors on Quality of Life (HINT-8) in Middle-Aged Korean Women: The Korea National Health and Nutrition Examination Survey.

Background: Obstructive sleep apnea and oral health are highly correlated with quality of life. The purpose of this study is to determine the mediating effect of self-cognitive oral health status on the effect of obstructive sleep apnea (OSA) risk factors on quality of life in middle-aged Korean women using the 2019 National Health and Nutrition Examination Survey data. Methods: A hierarchical regression analysis was performed on the mediating effect of self-cognitive oral health status on the effects of OSA risk factors on health-related quality of life (Korean health-related quality of life instrument with 8 items; HINT-8). Results: Self-cognitive oral health status as a parameter had a significant effect on quality of life (β = 0.713, p < 0.001). Compared to the effect of the OSA risk factor of the second stage on the quality of life (β = −1.329, p < 0.001), the input of the third stage of self-cognitive oral health was partially mediated (β = −1.280, p <0.001). Conclusions: Therefore, if middle-aged women have OSA risk factors, they should try to improve their quality of life by managing oral health as well as OSA treatment.

한국 중년 여성의 폐경 후 기간과 수면 시간의 관계

Objectives: This study aimed to investigate the relationship between the postmenopausal period and sleep duration in middle-aged Korean women using data from the eighth Korea National Health and Nutrition Examination Survey (VIII-2, 2020). Methods: The subjects were 1,455 middle-aged Korean women, and the study used complex sample frequency, descriptive statistics, cross analysis and multinominal logistic regression analysis. Results: The main finding revealed that sleep duration did not significantly correlate with the postmenopausal period after being simultaneously adjusted for general health behavior characteristics. However, “may be appropriate” sleep duration was significantly reduced in the absence of a spouse. “Not recommended” sleep duration was significantly reduced in the lower stress group that did not binge drink, and they displayed significantly increased poor health perception. Conclusion: Finally, it is necessary to re-examine the relationship between the postmenopausal period and sleep duration in middle-aged women, and it is worth considering whether to live with a spouse. In addition, it is important to practice responsible drinking behavior, improve stress management, and become aware of one’s own health.

A menopausal transition model based on transition theory.

The purpose of this study was to construct a hypothetical model based on Meleis and colleagues' Transition Theory and a literature review to explain women's menopausal transition, constructing a modified model considering previous studies and model fit and testing the effects between variables. With a correlational survey design, middle-aged Korean women aged 40 to 64 years who had experienced menopausal symptoms were recruited and filled out a self-administered study questionnaire. Measures included menopausal symptoms, resilience, social support, menopause management, menopause adaptation, and quality of life. The data were analyzed using SPSS 24.0 and AMOS 24.0. The model fit indices were considered acceptable: χ2 /degree of freedom=2.93, standardized root mean residual=.07, comparative fit index=.90, and parsimonious normed fit index=.73. All eight direct-effect paths-from menopausal symptoms to support and adaptation, from support to adaptation and resilience, from resilience to adaptation and management, from management to quality of life, and from adaptation to quality of life-were significant. The explanatory power of the menopause transition model was 63.6%. Women who experience menopausal symptoms may be able to maintain and improve their quality of life if menopause management and menopause adaptation are successful through resilience and social support. Future research is needed to confirm whether strengthening facilitation as a nursing intervention strategy may promote healthy response patterns.

Long-Term Alcohol Consumption Caused a Significant Decrease in Serum High-Density Lipoprotein (HDL)-Cholesterol and Apolipoprotein A-I with the Atherogenic Changes of HDL in Middle-Aged Korean Women.

Light-to-moderate alcohol drinking is associated with a low incidence of cardiovascular disease (CVD) via an elevation of high-density lipoproteins-cholesterol (HDL-C), particularly with the short-term supplementation of alcohol. However, there is no information on the change in the HDL qualities and functionalities between non-drinkers and mild drinkers in the long-term consumption of alcohol. This study analyzed the lipid and lipoprotein profiles of middle-aged Korean female non-drinkers, mild-drinkers, and binge-drinkers, who consumed alcohol for at least 10 years. Unexpectedly, the serum levels of HDL-C and apolipoprotein A-I (apoA-I) were decreased significantly depending on the alcohol amount; the binge-drinker group showed 18% and 13% lower HDL-C (p = 0.011) and apoA-I levels (p = 0.024), respectively, than the non-drinker group. Triglyceride (TG) and oxidized species, malondialdehyde (MDA), and low-density lipoproteins (LDL) levels were significantly elevated in the drinker groups. Interestingly, the binge-drinker group showed 1.4-fold higher (p = 0.020) cholesterol contents in HDL2 and 1.7-fold higher (p < 0.001) TG contents in HDL3 than those of the non-drinker group. The mild-drinker group also showed higher TG contents in HDL3 (p = 0.032) than the non-drinker group, while cholesterol contents were similar in the HDL3 of all groups. Transmission electron microscopy (TEM) showed that the non-drinker group showed a more distinct and clear particle shape of the LDL and HDL image with a larger particle size than the drinker group. Electrophoresis of LDL showed that the drinker group had faster electromobility with a higher smear band intensity and aggregation in the loading position than the non-drinker group. The HDL level of binge drinkers showed the lowest paraoxonase activity, the highest glycated extent, and the most smear band intensity of HDL and apoA-I, indicating that HDL quality and functionality were impaired by alcohol consumption. In conclusion, long-term alcohol consumption in middle-aged women, even in small amounts, caused a significant decrease in the serum HDL-C and apoA-I with atherogenic changes in LDL and HDL, such as an increase in TG and MDA content with a loss of paraoxonase activity.

Body fat distribution and insulin resistance among Korean middle-aged women: a Korean National Health and Nutrition Examination Survey.

ObjectiveTo evaluate menopause-related changes in body fat distribution and their relationship with insulin resistance in middle-aged Korean women.MethodsWe analyzed women aged 40–60 years using data from the National Health and Nutrition Examination Survey conducted from 2008 to 2011. Body fat was measured using dual-energy X-ray absorptiometry. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR).ResultsAmong 3,468 participants, menopausal women (n=1,489) had a higher body mass index (BMI) and higher trunk, arm, and head fat percentages than premenopausal women (n=1,979). However, no significant difference was found in the leg fat percentage according to menopausal status. Multivariable regression analysis for HOMA-IR showed that trunk fat percentage, BMI, and waist circumference positively correlated with insulin resistance and leg fat percentage negatively correlated after adjusting for several confounding factors, whereas menopausal status was not associated with HOMA-IR.ConclusionMiddle-aged women not only have different body weights and BMI but also have different body fat distributions according to menopausal status. Each fat percentage change in the trunk and leg is differently associated with metabolic health, particularly insulin resistance. To evaluate the metabolic health of middle-aged women, BMI is generally noted; however, body fat distribution, which can be easily assessed using dual-energy X-ray absorptiometry, should also be considered.

한국 중장년 여성의 악력에 따른 구강상태와 삶의 질(HINT-8)의 관련성

Objectives: The purpose of this study is to determine the relationship of grip strength on oral conditions and quality of life in middle-aged Korean women and to provide data to improve the importance of grip strength and oral health and quality of life.&#x0D; Methods: Data from the National Health and Nutrition Survey (2019) were used. For the purpose of the study, among 2,817 people excluding men, the final study subjects with sufficient data on grip strength were 2,504.&#x0D; Results: As for the effect of grip force on the quality of life of middle-aged women, as the grip strength increased, all difficulties in quality of life decreased, and difficulties in overall quality of life (-0.153) also decreased.&#x0D; Conclusions: Grip strength was confirmed that grip strength affects the oral condition, the need for dental treatment, the reason for visiting the dentist, and the quality of life of middle-aged women.

Predictors of Weight-Control Behavior in Healthy Weight and Overweight Korean Middle-Aged Women.

Although obesity level is considered to influence weight-control behavior, few studies have examined how predictors of weight-control behavior differ according to obesity level. We compared the predictors of weight-control behavior in healthy weight and overweight middle-aged Korean women. This study used a comparative cross-sectional design. In total, 352 middle-aged women (131 overweight and 221 healthy) who visited community centers in eight Korean cities participated in the study. Participants completed self-report questionnaires concerning perceived health, body dissatisfaction, health-related concerns, self-esteem, and weight-control behavior. Scores for weight-control behavior in the overweight group were higher than those in the healthy weight group. Stepwise multiple regression showed that health-related concerns, body dissatisfaction, socioeconomic status, and self-esteem predicted weight-control behavior in the overweight group. Perceived health, socioeconomic status, meal regularity, health-related concerns, and age predicted weight-control behavior in the healthy weight group. The findings indicate that nursing strategies should differ according to obesity level to improve weight-control behavior in middle-aged women. In community or clinical settings, nurses are advised to develop customized weight control programs based on obesity levels in middle-aged women.

Relationship between Religiosity and Subjective Well-Being among Middle-Aged Korean Women: Focused on Roles of Existential Consciousness and Savoring Beliefs

This study identified the relationship between religiosity and the subjective well-being of middle-aged Korean women, and examined a double mediating effect model of existential consciousness and savoring beliefs on this relationship. The participants of this study were 285 middle-aged Korean women, aged between 40–60 years. The PROCESS Macro 3.5 Model 6 was used to analyze the sequential double mediating effects. The results revealed that existential consciousness and savoring beliefs were positively correlated with the subjective well-being of middle-aged women, whereas their intrinsic religiosity was not significantly correlated with subjective well-being because it was positively correlated with negative emotions, as well as with life satisfaction and positive emotions. In a sequential double mediation model for the subjective well-being of middle-aged women, the direct effect of intrinsic religiosity on savoring beliefs was negatively significant after adjusting for indirect effects through existential consciousness. The sequential indirect effect of existential consciousness and savoring beliefs on the intrinsic religiosity and subjective well-being of middle-aged women was significant. Without these indirect effects, intrinsic religiosity negatively influenced middle-aged women’s subjective well-being in this model. These results suggest that existential consciousness plays an important role in the subjective well-being of middle-aged women.

Comparison of Vascular Function, Cardiometabolic Parameters, Hemorheological Function, and Cardiorespiratory Fitness Between Middle-Aged Korean Women With and Without Obesity-A Pilot Study.

This study aimed to compare vascular function, cardiometabolic parameters, hemorheological function, and cardiorespiratory fitness in middle-aged Korean women according to obesity defined using body mass index (BMI). A total of 32 Korean women aged between 34 and 60 years (16 without obesity, mean age 46.31 ± 7.49 years and 16 with obesity, mean age 49.68 ± 6.69 years) participated in this study. Obesity was defined as BMI ≥ 25 kg/m2. The body composition, vascular function, cardiometabolic parameters, hemorheological function, and cardiorespiratory fitness of all participants were measured. Statistical differences in the dependent parameters between individuals with and without obesity were analyzed, and the correlations between BMI and the dependent variables were verified. The obese group showed significantly worse results (p < 0.05) for body composition (significantly higher weight, BMI, fat mass, and percent body fat), vascular function [significantly higher branchial ankle pulse wave velocity (baPWV) and lower flow-mediated vasodilation (FMD)], cardiometabolic parameters [significantly higher insulin and homeostatic model assessment for insulin resistance (HOMA-IR)], hemorheological function (significantly lower erythrocyte deformability and higher aggregation), and cardiorespiratory fitness [significantly lower maximal oxygen uptake (VO2max)] compared to the non-obese group. In addition, BMI showed a significant positive correlation (p < 0.05) with baPWV (r = 0.430); total cholesterol (r = 0.376), triglyceride (r = 0.411), low-density lipoprotein cholesterol (r = 0.462), and insulin (r = 0.477) levels; HOMA-IR (r = 0.443); and erythrocyte aggregation (r = 0.406), and a significant negative correlation (p < 0.05) with VO2max (r = −0.482) and FMD (r = −0.412). Our study confirmed that obesity is a major determinant for deterioration of vascular function, cardiometabolic parameters, hemorheological function, and cardiorespiratory fitness.

Factors Influencing Physical Activity on Quality of Life in Urinary Incontinence

<h3>Research Objectives</h3> The objective of the present study was to investigate the impact of physical activity on the quality of life (QOL) of Korean middle-aged women with urinary incontinence (UI) by using the online questionnaire constructed for this study. <h3>Design</h3> This is an online survey study. An online survey was conducted between August 2020 and March 2021. This study was approved by the Yonsei University Mirae Campus Institutional Review Board (Approval Number. 1041849-202009-BM-106-02). <h3>Setting</h3> Data were collected via "Embrain"―an online research platform―and the convenience method. All questionnaires were conducted online. <h3>Participants</h3> A total of 250 middle-aged women between 40 and 69 years of age participated in this survey. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> The survey had a 61 questions and consisted of four parts: General information, Characteristics of UI, Incontinence Quality of Life (I-QOL), Physical activity-International Physical Activity Questionnaire (IPAQ), daily step count (DSC), physical activity at work (PAW), and the Borg scale during 1 min of sit-ups (BSS). <h3>Results</h3> The influences of independent variables on the scores of respondents in the I-QOL were examined using a hierarchical regression analysis. Variables for predicting I-QOL included severity, PAW, and the BSS, and IPAQ and DSC did not show significant results in the hierarchical regression analysis. <h3>Conclusions</h3> We investigated factors influencing the QOL of middle-aged Korean women with UI. The factors affecting I-QOL were PAW and BSS. Therefore, we recommend that occupational type and perceived exertion through muscular endurance testing elements should be included in UI assessment. <h3>Author(s) Disclosures</h3> The authors declare no conflicts of interest, and this study did not receive research funding.

Psychological well-being of midlife women: a structural equation modeling approach.

Women experience menopause at approximately 50 to 52 years of age, when reproductive aging causes various somatic, psychological, and urogenital symptoms. Women's changing lifestyles and increasing lifespan make it difficult to pinpoint the factors affecting their well-being during menopause, warranting continuous research in this field. Therefore, this study developed a structural equation model, based on the transactional model of stress and coping, to test the significance of positive and negative factors associated with psychological health during menopause. This study validated a structural equation model based on the empirical data collected using a crosssectional study. We analyzed 300 questionnaire responses completed between May 15 and July 10, 2020, by South Korean middle-aged women (aged 45-60 y) who agreed to participate. The study's structural equation model used self-efficacy as an exogenous variable and perceived stress, menopausal management, self-compassion, menopausal symptoms, and psychological well-being as endogenous variables. Educational and economic levels were set as control variables. We observed statistical support for 9 out of 10 hypotheses; the predictor variables had an explanatory power of 79.5% for psychological well-being. Self-efficacy was positively associated with the psychological wellbeing of middle-aged menopausal women and appeared to be mediated by perceived stress, menopausal management, menopausal symptoms, and self-compassion. To improve the psychological well-being of middle-aged women, it is important to increase their self-efficacy and minimize stress. Moreover, managing menopausal symptoms and increasing self-compassion through effective coping may maximize psychological well-being. http://links.lww.com/MENO/A933.

Association between Green Tea Consumption and Abdominal Obesity Risk in Middle-Aged Korean Population: Findings from the Korean Genome and Epidemiology Study.

The prevalence of general and abdominal obesity is increasing with rapid economic growth and the westernization of dietary habits in Korea, especially in the middle-aged population. Data were obtained from the Korean Genome and Epidemiology Study (KoGES), which recruited 10,030 participants between the ages of 40 and 69 years. Information on green tea consumption was obtained from the food frequency questionnaire and categorized as none, <1 cup, between 1 and <4 cups, and ≥4 cups. Multivariable logistic regression models were used to estimate the ORs and 95% CIs to examine any possible associations between green tea consumption and the risk of abdominal obesity after controlling for potential confounders. High consumption of green tea was associated with a 44% lower odds ratio for abdominal obesity (none vs. ≥4 cups/week: OR, 0.56; 95% CI 0.41-0.78; p for trend = 0.001). When stratified by sex, an inverse association between green tea consumption and abdominal obesity was observed only in women (none vs. ≥4 cups/week: OR, 0.71; 95% CI 0.57–0.88; p for trend = 0.004). No significant association was found among men. Our findings indicate that green tea consumption has beneficial effects in the prevention of abdominal obesity in middle-aged Korean women.

Effects of weight misperception on the association between BMI and self-rated health in midlife and elderly Koreans

ObjectivesThis study aimed to find whether weight misperception affected the relationship between measured body mass index (BMI) and self-rated health (SRH) in middle-aged and senior Koreans. MethodsA cross-sectional study was conducted in 8397 men and 11,211 women aged 40–80 years from the 2014–2018 Korea National Health and Nutrition Examination Survey using gender and age group (40–59 years and 60–80 years) specific moderation analysis and ordinal regression analysis of complex sampling design. BMI and weight misperception were the predictor and moderator, respectively. Outcome measure was SRH graded on very good to very poor scale. ResultsIn the group with accurate body weight estimation, the odds ratio of poorer SRH was greater in underweight or obese men and women aged 40–59 years and women aged 60–80 years compared to normal weight. However, in men aged 60–80 years who accurately estimated their weight, the odds ratio was higher in the underweight group but not in obese group. In the group that overestimated body weight, the odds ratio increased as the BMI category increased. In the group underestimating body weight, the odds ratio decreased in overweight or obese group than in the normal weight group. ConclusionsWeight misperception in middle-aged and older Korean men and women altered the relationship between BMI category and poorer SRH. Individuals who accurately estimated themselves as underweight regardless of gender or age and those who correctly identified themselves as obese in their middle years were the most likely to have poorer SRH.

Depressive symptoms and suicidality by menopausal stages among middle-aged Korean women.

There has been increasing evidence of hormonal changes during reproductive events that lead to mood changes. However, studies on the severity of psychological problems according to the menopausal stage are limited. Thus, this study aimed to investigate the association between menopausal stages, depression and suicidality. A total of 45 177 women who underwent regular health check-ups between 2015 and 2018 at Kangbuk Samsung Hospital were included. Participants were stratified into four groups (pre-menopause, early transition, late transition and post-menopause) based on the Stages of Reproductive Aging Workshop Criteria. The Center for Epidemiological Studies-Depression scale (CESD) was used to evaluate depressive symptoms, and the degree of depressive symptoms was classified as moderate (CESD score 16-24) or severe (CESD score ⩾ 25). To measure suicide risk, we administered questionnaires related to suicidal ideation. Overall, the prevalence of CESD scores of 16-24 and ⩾ 25 was 7.6 and 2.8%, respectively. Menopausal stages were positively associated with depressive symptoms in a dose-dependent manner. Multivariable-adjusted prevalence ratios (PRs, 95% confidence intervals) for CESD scores of 16-24 comparing the stages of the early menopausal transition (MT), late MT and post-menopause to pre-menopause was 1.28 (1.16-1.42), 1.21 (1.05-1.38) and 1.58 (1.36-1.84), respectively. The multivariable-adjusted PRs for CESD scores ⩾ 25 comparing the stages of the early MT, late MT and post-menopause to pre-menopause were 1.31 (1.11-1.55), 1.39 (1.12-1.72), 1.86 (1.47-2.37), respectively. In addition, the multivariable-adjusted PRs for suicidal ideation comparing the early MT, late MT and post-menopause stages to the pre-menopause stage were 1.24 (1.12-1.38), 1.07 (0.93-1.24) and 1.46 (1.25-1.70) (p for trend <0.001), respectively. These findings indicate that the prevalence of depressive symptoms and suicidal ideation increases with advancing menopausal stage, even pre-menopause.