Abstract：
OBJECTIVE: Menopausal transition, resulting from a decline in estrogen concentrations, may compromise musculoskeletal health. However, it is unclear if early menopause (defined as age at menopause <45 years) and premature ovarian insufficiency (defined as age at menopause <40 years) are associated with increased risk of sarcopenia. The aim of this systematic review and meta-analysis was to synthesize studies evaluating the association between age at menopause and risk of sarcopenia.
METHODS: A comprehensive search was conducted in PubMed, CENTRAL and Scopus, up to 31 December 2022. Data were expressed as standardized mean difference with 95 % confidence intervals. The I2 index was employed to evaluate heterogeneity.
RESULTS: Six studies were included in the qualitative and quantitative analysis, with a total of 18,291 post-menopausal women. Compared with women of normal age at menopause (>45 years), women with early menopause demonstrated lower muscle mass, assessed by appendicular skeletal muscle mass/body mass index [standardized mean difference (SMD) -0.14, 95 % confidence interval (CI) -0.20 to -0.07, p < 0.001; I2 0%]. However, no differences in muscle strength, assessed by handgrip strength (SMD -0.15, 95 % CI -0.31 to 0.01, p = 0.071; I2 72%), and muscle performance, assessed by gait speed (SMD -0.11, 95 % CI -0.29 to 0.05, p = 0.18; I2 79%), were found. Women with premature ovarian insufficiency had lower handgrip strength (SMD -0.3, 95 % CI -0.58 to -0.01, p = 0.04; I2 74.6 %) and gait speed (SMD -0.13, 95 % CI -0.23 to -0.04, p = 0.004; I2 0%) compared with women of normal age at menopause.
CONCLUSIONS: Early menopause is associated with reduced muscle mass and premature ovarian insufficiency with reduced muscle strength and performance compared with normal age at menopause.
METHODS: A comprehensive search was conducted in PubMed, CENTRAL and Scopus, up to 31 December 2022. Data were expressed as standardized mean difference with 95 % confidence intervals. The I2 index was employed to evaluate heterogeneity.
RESULTS: Six studies were included in the qualitative and quantitative analysis, with a total of 18,291 post-menopausal women. Compared with women of normal age at menopause (>45 years), women with early menopause demonstrated lower muscle mass, assessed by appendicular skeletal muscle mass/body mass index [standardized mean difference (SMD) -0.14, 95 % confidence interval (CI) -0.20 to -0.07, p < 0.001; I2 0%]. However, no differences in muscle strength, assessed by handgrip strength (SMD -0.15, 95 % CI -0.31 to 0.01, p = 0.071; I2 72%), and muscle performance, assessed by gait speed (SMD -0.11, 95 % CI -0.29 to 0.05, p = 0.18; I2 79%), were found. Women with premature ovarian insufficiency had lower handgrip strength (SMD -0.3, 95 % CI -0.58 to -0.01, p = 0.04; I2 74.6 %) and gait speed (SMD -0.13, 95 % CI -0.23 to -0.04, p = 0.004; I2 0%) compared with women of normal age at menopause.
CONCLUSIONS: Early menopause is associated with reduced muscle mass and premature ovarian insufficiency with reduced muscle strength and performance compared with normal age at menopause.
摘要：
目的：更年期过渡，由于雌激素浓度下降，可能会损害肌肉骨骼健康。然而,目前尚不清楚早绝经(定义为绝经年龄<45岁)和早卵巢功能不全(定义为绝经年龄<40岁)是否与肌肉减少症风险增加相关.本系统综述和荟萃分析的目的是综合评估绝经年龄与肌肉减少症风险之间关系的研究。
方法：在PubMed中进行了全面搜索，CENTRAL和Scopus,至2022年12月31日。数据表示为具有95%置信区间的标准化平均差。采用I2指数评价异质性。
结果：六项研究纳入了定性和定量分析，共有18,291名绝经后妇女。与正常年龄（>45岁）的绝经期妇女相比，绝经早期的女性肌肉质量较低，通过阑尾骨骼肌质量/体重指数评估[标准化平均差（SMD）-0.14，95％置信区间（CI）-0.20至-0.07，p<0.001；I20％]。然而,肌肉力量没有差异，按握力评估（SMD-0.15，95%CI-0.31至0.01，p=0.071；I272%），和肌肉表现，通过步态速度评估（SMD-0.11，95%CI-0.29至0.05，p=0.18；I279%），被发现了。与绝经时正常年龄的女性相比，过早卵巢功能不全的女性的握力较低（SMD-0.3，95％CI-0.58至-0.01，p=0.04；I274.6％）和步态速度较低（SMD-0.13，95％CI-0.23至-0.04，p=0.004；I20％）。
结论：与绝经时的正常年龄相比，早期绝经与肌肉量减少和过早卵巢功能不全相关，肌肉力量和表现降低。
方法：在PubMed中进行了全面搜索，CENTRAL和Scopus,至2022年12月31日。数据表示为具有95%置信区间的标准化平均差。采用I2指数评价异质性。
结果：六项研究纳入了定性和定量分析，共有18,291名绝经后妇女。与正常年龄（>45岁）的绝经期妇女相比，绝经早期的女性肌肉质量较低，通过阑尾骨骼肌质量/体重指数评估[标准化平均差（SMD）-0.14，95％置信区间（CI）-0.20至-0.07，p<0.001；I20％]。然而,肌肉力量没有差异，按握力评估（SMD-0.15，95%CI-0.31至0.01，p=0.071；I272%），和肌肉表现，通过步态速度评估（SMD-0.11，95%CI-0.29至0.05，p=0.18；I279%），被发现了。与绝经时正常年龄的女性相比，过早卵巢功能不全的女性的握力较低（SMD-0.3，95％CI-0.58至-0.01，p=0.04；I274.6％）和步态速度较低（SMD-0.13，95％CI-0.23至-0.04，p=0.004；I20％）。
结论：与绝经时的正常年龄相比，早期绝经与肌肉量减少和过早卵巢功能不全相关，肌肉力量和表现降低。
