目的:女性性功能障碍(FSD)被大大低估了。已经反复报道患有心血管疾病(CVD)的患者可能患有FSD的风险增加。然而,目前尚缺乏对各种CVD和FSD的全面系统评价。我们旨在通过全面的文献综述和荟萃分析阐明心血管疾病和FSD之间的关联。
结果:PubMed,Scopus,Embase,和Cochrane图书馆数据库从开始到2023年2月28日进行了系统搜索。我们确定了所有相关研究报告有或没有CVD的受试者的FSD风险。通过计算95%CI的合并OR(横断面研究)和RR(纵向研究)评估CVD与FSD风险之间的关联。我们采用随机效应模型来解释潜在的异质性,纳入研究的质量采用纽卡斯尔-渥太华量表(NOS)进行评估。我们的荟萃分析包括54篇文章,148,946人。与对照组相比,心血管疾病患者的FSD风险增加1.51倍(OR1.5195%CI,1.34-1.69,P<.001,异质性I2=91.4%,P<.001)。亚组分析表明,在纵向研究中,CVD和FSD之间的关联仍然显着(RR1.5095%CI,1.21-1.86,P<.001,异质性I2=86.7%,P<.001)。特别是,高血压(OR1.4195%CI,1.23-1.62,P<.001,异质性I2=82.7%,P<.001),卒中(OR1.8195%CI,1.54-2.12,P<.001,异质性I2=0%,P<.423),和心肌梗死(OR2.0795%CI,1.60-2.67,P<.001异质性I2=82.4%,P<.001)与FSD显著相关。Meta回归显示,FSD异质性的主要来源可归因于协变量的调整,研究设计,研究人口。
结论:我们的荟萃分析表明,CVD患者发生FSD的风险更大。同时,我们在纵向队列中验证了这些发现.值得注意的是,如高血压,中风,心肌梗死与FSD的发病率显著相关。
作为迄今为止最全面的系统分析,我们的研究提供了显著的优势。它涵盖了45项横断面研究和11项纵向研究,涉及148,946名患者,旨在探讨不同类型的CVD与FSD的关系。进行亚组分析以探讨区域和发表时间等因素的影响。*越来越多的证据强烈支持心血管疾病和FSD风险增加之间的显著联系,特别是在高血压的情况下,中风,和心肌梗塞。这些结果表明,应该更加关注女性的性健康,特别是在CVD的存在下。*未来的研究有必要调查药物干预对受CVD影响的女性性功能的影响。
OBJECTIVE: Female sexual dysfunction (FSD) is a considerably underestimated condition. It has been repeatedly reported that patients with cardiovascular diseases (CVD) may suffer from an increased risk of FSD. However, there is still a lack of comprehensive and systematic evaluation of various CVD and FSD. We aimed to elucidate the association between CVD and FSD through a comprehensive literature review and meta-analysis.
RESULTS: The PubMed, Scopus, Embase, and Cochrane Library databases were systematically searched from inception to 28 February 2023. We identified all relevant studies reporting the risk of FSD in subjects with or without CVD. The associations between CVD and the risk of FSD were assessed by calculating pooled odds ratios (ORs) (cross-sectional studies) and risk ratios (RRs) (longitudinal studies) with 95% CIs. We employed random-effects models to account for potential heterogeneity, and the quality of the included studies was assessed using the Newcastle-Ottawa Scale. Fifty-four articles with 148 946 individuals were included in our meta-analysis. Compared with control subjects, subjects with CVD had a 1.51-fold increased risk of FSD (OR 1.51 95% CI, 1.34-1.69, P < 0.001, heterogeneity I2 = 91.4%, P < 0.001). Subgroup analyses indicated that the association between CVD and FSD remained significant in longitudinal studies (RR 1.50 95% CI, 1.21-1.86, P < 0.001, heterogeneity I2 = 86.7%, P < 0.001). Particularly, hypertension (OR 1.41 95% CI, 1.23-1.62, P < 0.001, heterogeneity I2 = 82.7%, P < 0.001), stroke (OR 1.81 95% CI, 1.54-2.12, P < 0.001, heterogeneity I2 = 0%, P < 0.423), and myocardial infarction (OR 2.07 95% CI, 1.60-2.67, P < 0.001 heterogeneity I2 = 82.4%, P < 0.001) were significantly associated with FSD. Meta-regression revealed that the primary sources of heterogeneity in FSD are attributable to adjustments for covariates, study design, and study population.
CONCLUSIONS: Our meta-analysis indicated that patients with CVD suffer from a greater risk of developing FSD. Meanwhile, we validated these findings in longitudinal queues. Notably, conditions such as hypertension, stroke, and myocardial infarction demonstrated a significant association with the incidence of FSD.
Our study provides a significant advantage as the most comprehensive systematic analysis to date. It encompassed 45 cross-sectional and 11 longitudinal studies with 148 946 patients, aiming to investigate the relationship between various types of cardiovascular diseases (CVD) and female sexual dysfunction (FSD). Subgroup analyses were conducted to explore the impact of factors such as region and publication time.Accumulating evidence strongly supports a significant link between CVD and an increased risk of FSD, especially in cases of hypertension, stroke, and myocardial infarction. These findings indicate that more attention should be paid to women’s sexual health, particularly in the presence of CVD.Future studies are warranted to investigate the effects of pharmacological interventions on the sexual function of women affected by CVD.