■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.