Early menopause

早期更年期
  • 文章类型: Journal Article
    更年期标志着生命生殖阶段的结束。根据流行病学研究,自然绝经年龄异常(ANM)被认为是导致许多不良后果的原因,比如骨质疏松症,心血管疾病,和癌症。然而,这些关联的因果关系尚不清楚.一种称为孟德尔随机化(MR)的强大流行病学方法可用于阐明ANM与其他疾病或性状之间的因果关系。本综述描述了包括ANM作为暴露的MR研究,结果和调解人。对ANM的MR分析结果表明,较高的体重指数,教育水平差,初潮时年龄较早,第一次活产时的早期年龄,在第一次性交的早期,自身免疫性甲状腺疾病似乎与早期ANM病因有关。晚期ANM的病因似乎受到较高的游离甲状腺素4和亚甲基四氢叶酸还原酶基因突变的影响。此外,已发现早期ANM与骨质疏松症风险增加有因果关系。骨折,2型糖尿病,糖化血红蛋白,和胰岛素抵抗水平的稳态模型。此外,已发现晚期ANM与收缩压升高有因果关系,患乳腺癌的风险更高,子宫内膜癌,子宫内膜样卵巢癌,肺癌,长寿,气流阻塞,并降低患帕金森病的风险。ANM也是由出生体重和儿童体型引起的乳腺癌的介质。然而,由于使用的工具变量不同,一些研究结果不一致。对于MR之间或MR与其他类型的流行病学研究之间存在差异的性状,需要具有更有效的遗传变异的未来研究。
    Menopause marks the end of the reproductive phase of life. Based on epidemiological studies, abnormal age at natural menopause (ANM) is thought to contribute to a number of adverse outcomes, such as osteoporosis, cardiovascular disease, and cancer. However, the causality of these associations remains unclear. A powerful epidemiological method known as Mendelian randomization (MR) can be used to clarify the causality between ANM and other diseases or traits. The present review describes MR studies that included ANM as an exposure, outcome and mediator. The findings of MR analyses on ANM have revealed that higher body mass index, poor educational level, early age at menarche, early age at first live birth, early age at first sexual intercourse, and autoimmune thyroid disease appear to be involved in early ANM etiology. The etiology of late ANM appears to be influenced by higher free thyroxine 4 and methylene tetrahydrofolate reductase gene mutations. Furthermore, early ANM has been found to be causally associated with an increased risk of osteoporosis, fracture, type 2 diabetes mellitus, glycosylated hemoglobin, and the homeostasis model of insulin resistance level. In addition, late ANM has been found to be causally associated with an increased systolic blood pressure, higher risk of breast cancer, endometrial cancer, endometrioid ovarian carcinoma, lung cancer, longevity, airflow obstruction, and lower risk of Parkinson\'s disease. ANM is also a mediator for breast cancer caused by birth weight and childhood body size. However, due to the different instrumental variables used, some results of studies are inconsistent. Future studies with more valid genetic variants are needed for traits with discrepancies between MRs or between MR and other types of epidemiological studies.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Meta-Analysis
    目的:更年期与心血管疾病的高风险有关。然而,尚不清楚过早绝经(定义为40岁之前绝经)或过早绝经(定义为45岁之前绝经)是否与心力衰竭或心房颤动风险增加相关.这项研究旨在检查有关绝经早期与心力衰竭和心房颤动风险之间关系的最可靠证据。
    方法:在三个在线数据库中进行了全面的文献检索,Embase,WebofScience,和PubMed,从数据库建立到2023年4月1日。结果表示为具有95%置信区间的风险比。I2统计量用于评估异质性,并使用Egger检验来确定发表偏倚。
    结果:九项队列研究被纳入分析,共有6,255,783名绝经后妇女。与45岁后绝经的女性相比,过早绝经和早绝经的女性发生心力衰竭的风险增加(HR:1.39,95%CI:1.31-1.47;HR:1.23,95%CI:1.10-1.37)和心房颤动(HR:1.15,95%CI:1.01-1.31;HR:1.08,95%CI:1.04-1.13)。亚组分析显示,与绝经早期相比,过早绝经与心力衰竭和心房颤动的风险增加有更强的关联。
    结论:与正常年龄范围内绝经的女性相比,绝经提前或提前绝经的女性发生心力衰竭和心房颤动的风险更高。需要考虑这些生殖因素,以采取可能降低心力衰竭和心房颤动风险的措施。
    OBJECTIVE: Menopause is linked to a higher risk of cardiovascular disease. However, it is unclear whether premature menopause (defined as menopause before the age of 40 years) or early menopause (defined as menopause before the age of 45 years) is associated with an increased risk of heart failure or atrial fibrillation. This study aimed to examine the most reliable evidence on the relationship between early menopause and the risk of heart failure and atrial fibrillation.
    METHODS: A comprehensive literature search was performed in three online databases, Embase, Web of Science, and PubMed, from database establishment to April 1, 2023. The results were presented as hazard ratios with 95 % confidence intervals. The I2 statistic was employed to assess heterogeneity, and the Egger\'s test was used to determine publication bias.
    RESULTS: Nine cohort studies were included in the analysis, with a total of 6,255,783 postmenopausal women. Women with premature and early menopause had an increased risk of heart failure (HR: 1.39, 95 % CI: 1.31-1.47; HR: 1.23, 95 % CI: 1.10-1.37, respectively) and atrial fibrillation (HR: 1.15, 95 % CI: 1.01-1.31; HR: 1.08, 95 % CI: 1.04-1.13, respectively) when compared with women who had undergone menopause after the age of 45 years. Subgroup analysis showed that, compared with early menopause, premature menopause has a stronger association with an increased risk of heart failure and atrial fibrillation.
    CONCLUSIONS: Women who undergo premature menopause or early menopause have a higher risk of heart failure and atrial fibrillation compared with women who undergo menopause in the normal age range. These reproductive factors need to be considered for measures that might reduce the risk of heart failure and atrial fibrillation.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Meta-Analysis
    目标:在其他危险因素中,绝经期间雌激素浓度的下降可能会损害认知功能。早期绝经(EM)是否与痴呆症风险增加有关尚不清楚。这项研究的目的是系统回顾和荟萃分析有关EM或卵巢早衰(POI)与任何类型痴呆风险之间关联的现有证据。
    方法:通过PubMed进行了全面的文献检索,截至2022年8月的Scopus和CENTRAL数据库。使用纽卡斯尔-渥太华量表评估研究质量。关联计算为比值比(OR),95%置信区间(CI)。I2指数用于异质性。
    结果:11项研究(9项评估为良好,2项评估为一般质量)纳入荟萃分析(n=4,716,862)。与绝经时正常年龄的女性相比,患有EM的女性患痴呆的风险更高(OR1.37,95%CI1.22-1.54;I293%)。然而,排除大型回顾性队列研究后,结果改变(OR1.07,95%CI0.78-1.48;I294%)。患有POI的女性患痴呆的风险也增加(OR1.18,95%CI1.15-1.21;I20%)。亚组分析显示,这种风险在队列研究中最为明显,包括自然更年期女性。
    结论:患有EM或POI的女性在绝经时与正常年龄的女性相比,患痴呆的风险增加,但进一步的研究调查这一假设是有必要的。
    OBJECTIVE: Among other risk factors, the decline in estrogen concentrations during menopause may compromise cognitive function. Whether early menopause (EM) is associated with an increased risk of dementia remains unclear. The purpose of this study was to systematically review and meta-analyze current evidence regarding the association between EM or premature ovarian insufficiency (POI) and the risk of dementia of any type.
    METHODS: A comprehensive literature search was conducted through the PubMed, Scopus and CENTRAL databases up to August 2022. Study quality was assessed using the Newcastle-Ottawa scale. Associations were calculated as odds ratio (OR) with 95 % confidence interval (CI). The I2 index was employed for heterogeneity.
    RESULTS: Eleven studies (nine assessed as of good and two as of fair quality) were included in the meta-analysis (n = 4,716,862). Women with EM demonstrated a greater risk of dementia of any type than women of normal age at menopause (OR 1.37, 95 % CI 1.22-1.54; I2 93%). However, after excluding a large retrospective cohort study, the results were altered (OR 1.07, 95 % CI 0.78-1.48; I2 94%). Increased risk of dementia was also found in women with POI (OR 1.18, 95 % CI 1.15-1.21; I2 0%). Subgroup analysis showed that this risk was mostly evident in cohort studies, and those which included women with natural menopause.
    CONCLUSIONS: Women with EM or POI may be at increased risk of dementia compared with women of normal age at menopause, but further research investigating that hypothesis is warranted.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Meta-Analysis
    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。
    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.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在35至45岁之间,对患有卵巢癌的高遗传风险妇女进行降低风险的输卵管卵巢切除术(RRSO)。虽然有可能挽救生命,RRSO可能会引起对生活质量产生负面影响并损害长期健康的症状。RRSO后的临床护理通常是次优的。本范围审查描述了RRSO如何影响短期和长期健康,并为从术前咨询到长期疾病预防的护理提供了基于证据的国际共识建议。这包括激素和非激素治疗血管舒缩症状的疗效和安全性,睡眠障碍和性功能障碍以及预防骨骼和心血管疾病的有效方法。
    Women at high inherited risk of ovarian cancer are offered risk-reducing salpingo-oophorectomy (RRSO) from age 35 to 45 years. Although potentially life-saving, RRSO may induce symptoms that negatively affect quality of life and impair long-term health. Clinical care following RRSO is often suboptimal. This scoping review describes how RRSO affects short- and long-term health and provides evidence-based international consensus recommendations for care from preoperative counselling to long-term disease prevention. This includes the efficacy and safety of hormonal and non-hormonal treatments for vasomotor symptoms, sleep disturbance and sexual dysfunction and effective approaches to prevent bone and cardiovascular disease.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    过渡到更年期与心血管疾病(CVD)的风险增加有关。然而,尚不清楚绝经过早(定义为绝经年龄40岁)或绝经早期(定义为绝经年龄40~45岁)与CVD或心血管危险因素之间是否存在关联.这篇综述的目的是全面评估和荟萃分析关于绝经年龄与长期心脏代谢疾病风险之间关系的最可靠证据。
    PubMed的全面文献检索,WebofScience,从成立到2022年10月1日的Embase数据库,用于标题和摘要,但仅限于英语论文,导致了研究的发现。数据表示为具有95%置信区间(CI)的危险比(HR)。使用I平方(I2)指数测量异质性的程度。
    921,517名参与者来自1998年至2022年之间发表的20项队列研究。与绝经年龄>45岁的女性相比,绝经提前(PM)或绝经提前(EM)的女性患2型糖尿病的风险较高(RR:1.32,95%CI:1.08-1.62;RR:1.11,95%CI:0.91-1.36),高脂血症(RR:1.21,95%CI:1.05-1.39;RR:1.17,95%CI:1.02-1.33),冠心病(RR:1.52,95%CI:1.22-1.91;RR:1.19,95%CI:1.07-1.32),卒中(RR:1.27,95%CI:1.02-1.58;RR:1.13,95%CI:0.97-1.32)和总心血管事件(RR:1.36,95%CI:1.16-1.60;RR:1.14,95%CI:0.97-1.35).PM或EM女性的高血压无差异(RR:0.98,95%CI:0.89-1.07;RR:0.97,95%CI:0.91-1.04)。此外,我们还发现PM女性,但不是女性,与缺血性和出血性中风的风险增加有关。然而,这与PM和EM均有更高的总卒中风险的结论不一致.
    患有PM或EM的女性患长期心血管疾病的风险更高,与绝经年龄>45岁的女性相比。因此,我们建议早期生活方式干预(例如,保持健康的生活方式)和医疗(例如,及时开始绝经激素治疗),以降低早期或过早绝经妇女患心脏代谢疾病的风险。
    PROSPERO,标识符CRD42022378750。
    UNASSIGNED: Transition into menopause is associated with an increased risk of cardiovascular disease (CVD). However, it is unclear whether the association exists between premature menopause (defined as age at menopause 40 years) or early menopause (defined as age at menopause 40-45 years) and CVD or cardiovascular risk factors. The aim of this review was to comprehensively evaluate and meta-analyze the most reliable evidence about the relationship between menopausal age and the risk of long-term cardiometabolic disease.
    UNASSIGNED: A comprehensive literature search of the PubMed, Web of Science, and Embase databases from inception to October 1, 2022, for titles and abstracts with a restriction to English language papers led to the discovery of the studies. Data are expressed as the Hazard Ratio (HR) with 95% confidence intervals (CI). The degree of heterogeneity was measured using the I-square (I 2) index.
    UNASSIGNED: 921,517 participants from 20 cohort studies published between 1998 and 2022 were considered. Compared to women with menopause at age >45 years, women with premature menopause (PM) or early menopause (EM) had a higher risks of type 2 diabetes (RR: 1.32, 95% CI: 1.08-1.62; RR: 1.11, 95% CI: 0.91-1.36, respectively), hyperlipidemia (RR: 1.21, 95% CI: 1.05-1.39; RR: 1.17, 95% CI: 1.02-1.33, respectively), coronary heart disease (RR: 1.52, 95% CI: 1.22-1.91; RR: 1.19, 95% CI: 1.07-1.32, respectively), stroke (RR: 1.27, 95% CI: 1.02-1.58; RR: 1.13, 95% CI: 0.97-1.32, respectively) and total cardiovascular event (RR: 1.36, 95% CI: 1.16-1.60; RR: 1.14, 95% CI: 0.97-1.35, respectively). No difference was found for hypertension in PM or EM women (RR: 0.98, 95% CI: 0.89-1.07; RR: 0.97, 95% CI: 0.91-1.04, respectively). Additionally, we also found that PM women, but not EM women, were linked with an increased risk of ischemic and hemorrhagic stroke. However, this is not in line with the conclusion that both PM and EM had a higher risk of total stroke.
    UNASSIGNED: Women with PM or EM have a higher risk of developing long-term CVD, compared to women with menopause at age >45 years. Therefore, we recommend early lifestyle interventions (e.g., maintaining a healthy lifestyle) and medical treatments (e.g., timely initiation of menopausal hormone therapy) to decrease the risk of cardiometabolic disease in early or premature menopausal women.
    UNASSIGNED: PROSPERO, identifier CRD42022378750.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    有人建议饮食在决定自然更年期的年龄方面发挥作用;然而,证据不一致。
    我们系统地回顾和评估了已发表的关于饮食与自然更年期(ONM)之间关系的研究。
    我们搜索了6个数据库(Medline,Embase,科克伦,PubMed,WebofScience和GoogleScholar)至2021年1月21日,以确定评估饮食与ONM之间关联的前瞻性研究。两个独立的审阅者使用预先设计的数据收集表单提取数据。使用随机效应模型计算集合危险风险(HR)。
    在我们审查的6137份合格参考文献中,我们在最终分析中包括了15篇文章。这15篇文章包括在随访期间经历自然更年期的298,413名妇女中的91,554名妇女。总的来说,调查了89个食物组,38种常量营养素和微量营养素,和6种饮食模式。在食物群体中,绿色和黄色蔬菜的摄入量较高与ONM的年龄较早有关,虽然一些乳制品的摄入量很高,比如低脂肪,脱脂奶,酒精摄入量低与发病晚有关。我们观察到大量营养素和微量营养素摄入量与ONM之间没有一致的关联。我们的结果表明,素食可能与早期ONM有关;我们没有观察到其他饮食模式的任何其他一致效果。限制包括研究的数量,缺乏复制研究,且研究具有观察性;大多数研究(11/15)存在中等偏倚风险.
    虽然有些食物与ONM有关,关于饮食与ONM之间关联的总体证据仍存在争议.Prosperoid:CRD42021232087。
    Diet has been suggested to play a role in determining the age at natural menopause; however, the evidence is inconsistent.
    We systematically reviewed and evaluated published research about associations between diet and onset of natural menopause (ONM).
    We searched 6 databases (Medline, Embase, Cochrane, PubMed, Web of Science and Google Scholar) through January 21,2021 to identify prospective studies assessing the association between diet and ONM. Two independent reviewers extracted data using a predesigned data-collection form. Pooled hazard risks (HRs) were calculated using random effect models.
    Of the 6,137 eligible references we reviewed, we included 15 articles in our final analysis. Those 15 articles included 91,554 women out of 298,413 who experienced natural menopause during follow-up. Overall, there were 89 food groups investigated, 38 macronutrients and micronutrients, and 6 dietary patterns. Among the food groups, higher intake of green and yellow vegetables was associated with earlier age of ONM, while high intakes of some dairy products, such as low-fat, skimmed milk, and low intake of alcohol were associated with a later onset. We observed no consistent association between macronutrient and micronutrient intake and ONM. Our results suggests that a vegetarian diet could be associated with early ONM; we did not observe any other consistent effect from other dietary patterns. Limitations included the number of studies, lack of replication studies and the research being of an observational nature; most studies (11/15) were at medium risk of bias.
    Although some food items were associated with ONM, the overall evidence about associations between diet and ONM remains controversial. Prospero id: CRD42021232087.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    目的:更年期过渡与心血管疾病(CVD)的风险增加有关,主要归因于动脉粥样硬化的血脂异常,中心性肥胖和胰岛素抵抗。目前尚不清楚动脉高血压(AH)是否也与更年期相关的CVD有关。这项研究的目的是系统地调查和荟萃分析有关早期绝经(EM)与AH风险之间关联的最佳可用证据。
    方法:在PubMed中进行了全面搜索,CENTRAL和Scopus数据库,直到1月20日,2020年。数据表示为比值比(OR),95%置信区间(CI)。I2指数用于异质性。
    结果:10项研究纳入定量分析(273,994名绝经后妇女,76853例与AH)。与正常年龄(>45岁)的绝经女性相比,EM(绝经年龄<45岁)的AH风险更高(OR1.10,95%CI1.01-1.19,p=0.03;I279%)。当分析仅限于包括潜在混杂因素匹配组的研究时,这种关联的方向或大小仍然很重要。比如年龄,BMI,吸烟或使用更年期激素治疗或口服避孕药。
    结论:与正常年龄的女性相比,绝经后女性患AH的风险增加。
    OBJECTIVE: Menopausal transition has been associated with an increased risk of cardiovascular disease (CVD), mainly attributed to atherogenic dyslipidaemia, central obesity and insulin resistance. Whether arterial hypertension (AH) also contributes to menopause-associated CVD is currently unknown. The aim of this study was to systematically investigate and meta-analyze the best available evidence regarding the association between early menopause (EM) and AH risk.
    METHODS: A comprehensive search was conducted in PubMed, CENTRAL and Scopus databases, up to January 20th, 2020. Data were expressed as odds ratio (OR) with 95 % confidence intervals (CI). The I2 index was employed for heterogeneity.
    RESULTS: Ten studies were included in the quantitative analysis (273,994 postmenopausal women, 76853 cases with AH). Women with EM (age at menopause <45 years) were at higher AH risk compared with those of normal age at menopause (>45 years) (OR 1.10, 95 % CI 1.01-1.19, p = 0.03; I2 79 %). The direction or the magnitude of this association remained significant when the analysis was restricted to studies including groups matched for potential confounders, such as age, BMI, smoking or the use of menopausal hormone therapy or oral contraceptives.
    CONCLUSIONS: Women with EM have an increased risk for AH compared with those of normal age at menopause.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Sci-hub)

  • 文章类型: Journal Article
    更年期早期(EM,绝经年龄<45岁)和过早卵巢功能不全(POI,绝经年龄<40岁)与骨质疏松症的风险增加有关。然而,它们与骨折风险增加的关联尚未确定,研究结果相互矛盾。本系统综述和荟萃分析的主要目的是综合评估绝经年龄与骨折风险之间关系的研究。次要目的是评估有关骨折部位的这种影响。
    在PubMed中进行了全面搜索,CENTRAL和Scopus,截至2018年1月31日。数据表示为比值比(OR),95%置信区间(CI)。I2指数用于量化异质性。
    18项研究纳入了定性和定量分析(462,393名绝经后妇女,12130处骨折)。与绝经年龄>45岁的女性相比,女性EM患者骨折风险较高(OR1.36,95%CI1.11-1.66,p<0.002,I²81.5%).与绝经年龄>40岁(OR1.23,95%CI0.72-2.09,p=0.436,I²62.5%)或>45岁(OR0.54,95%CI0.22-1.29,p=0.17,I20%)的女性相比,患有POI的女性骨折风险没有任何差异。当对椎骨进行单独分析时,没有明显差异,非椎骨和髋部骨折。
    这是首次荟萃分析,显示与绝经时正常年龄相比,EM与骨折风险增加有关。对骨折部位没有任何明显的影响。
    Early menopause (EM, age at menopause < 45 years) and premature ovarian insufficiency (POI, age at menopause < 40 years) are associated with an increased risk of osteoporosis. However, their association with increased fracture risk has not been established, with studies yielding conflicting results. The primary aim of this systematic review and meta-analysis was to synthesize studies evaluating the association between age at menopause and fracture risk. The secondary aim was to evaluate this effect concerning the site of fractures.
    A comprehensive search was conducted in PubMed, CENTRAL and Scopus, up to 31 January 2018. Data were expressed as odds ratio (OR) with 95% confidence intervals (CI). The I2 index was employed for quantifying heterogeneity.
    Eighteen studies were included in the qualitative and quantitative analysis (462,393 postmenopausal women, 12,130 fractures). Compared with women with age at menopause > 45 years, women with EM demonstrated higher fracture risk (OR 1.36, 95% CI 1.11-1.66, p < 0.002, I² 81.5%). Women with POI did not display any difference in fracture risk compared either with women with age at menopause > 40 (OR 1.23, 95% CI 0.72-2.09, p = 0.436, I² 62.5%) or >45 years (OR 0.54, 95% CI 0.22-1.29, p = 0.17, I2 0%). No difference was evident when a separate analysis was performed for vertebral, non-vertebral and hip fractures.
    This is the first meta-analysis showing that EM is associated with increased fracture risk compared with normal age at menopause, without any distinct effect on the site of the fracture.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号