Study participants

This cross-sectional study enrolled participants who visited the Menopause Clinic in the Shanghai Sixth Peoples Hospital. Han-Chinese woman aged 4067years passing through the menopause were recruited. Exclusion criteria were (1) with rhinitis; (2) having severe internal illnesses and/or diseases such as myocardial infarction, stroke, and cancer; (3) current smoking (at least once per week for the previous 6months); (4) excessive alcohol drinking (at least one pack per month for the previous 6months); (5) suffering from thyroid disease; (6) having tubercle and cachexy; (7) missing data. Ultimately,715 participants were recruited in this study.

Baseline sociodemographic information was collected from a questionnaire through face-to-face interview, which has been previously employed [8] (seen in supplementary file1); Variables included age, marital status, employment status, education level, income per month, menopausal age, menopausal status, history of chronic disease (i.e., hypertension, diabetes mellitus, rhinitis, other diseases), besides, lifestyle (i.e., smoke, alcohol consumption) were recorded. Guiding by the Stages of Reproductive Aging Workshop (STRAW +10) [15],participants were divided into three different menopausal subgroups, namely menopausal transition group (consecutive irregularities for over 7days of menstrual cycle), early postmenopausal group (absence of menstrual periods for 12months 5years) and late postmenopausal group (absence of menstrual periods for 5years). Hypertension was defined by any prior diagnosis from the questionnaire or by the criteria recommended by the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7, [16]). While diabetes mellitus was identified by FPG7mmol/L or received any treatment for diabetes according to the WHO criteria [17].

Participants were asked by the question to assess the sleep snoring frequency, which was applied previously [18, 19]. Over the past 4 weeks, did you snore? And if did, how many times per week? and the options for responses were never, rarely, occasionally, and regularly, corresponding to never, <1 night per week, 12 nights per week, and 3 nights per week, respectively (seen in supplementary file1).

We measured and recorded participants weight, height. Body mass index (BMI) was computed by dividing weight in kilograms by the square of their height in meters. We took the blood pressure for all participants on the right arm three consecutive times after 5-min sitting (systolic blood pressure (SBP), diastolic blood pressure (DBP)). Blood samples were collected for the detection of serum concentration of triglyceride (TG), cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and fasting blood glucose (FBG) after an overnight fast.

We measured the body composition by BIA (TBF-418B analyzer; TANITA) of lean mass (LM), fat mass (FM), and fat-free mass (FFM), and each segment included upper /lower limbs, and trunk. We also recorded basal metabolic rate (BMR) concurrently [20]. The well-trained staff guided the participants to take off heavy clothes, socks and shoes, and hold the hand electrodes, standing barefoot in contact with footpad electrodes [21]. Fat mass (total and each segment) and lean mass (total and each segment) were stated in the dichotomized form, with a cutoff of the highest quartile as the higher one (comparing the highest to the lower two tertiles). We defined 17.11kg, 1.41kg and9.11kg as higher total fat mass, higher fat mass of upper limbs and higher fat mass of trunk respectively.

All statistical analyses were taken by SPSS 22.0 (IBM Corporation, Armonk, NY, USA). Data were tested for normal distribution by the Kruskal WallisH-test. Levenes test of homogeneity of variance was also performed. Variables were presented as meanstandard deviation (SD) when they showed normal distributions, whereas medians (inter quartile range) or values (%). One-way ANOVA (normal distributions), the Kruskal Wallis H-test (skewed continuous variables) and 2 test (categorical variables) were carried out to compare the differences among the four groups. Snoring was analyzed as a categorical variable with never as the reference group. Relationship between body composition and snoring frequency was computed by multiple logistic regression analysis. Covariates included TG, TC, HDL, LDL, FBG, SBP, DBP, age, marital status, employment status, education level, income per month, menopausal age, menopausal status, hypertension, diabetes mellitus. Two-sided p<0.05 was considered significant.

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Association of snoring and body composition in (peri-post) menopausal women - BMC Blogs Network

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