Hardy R, Kuh D
Medical Research Council National Survey of Health and Development, Department of Epidemiology and Public Health, Royal Free and University College Medical School, London WC1E 6BT, UK.
Hum Reprod. 2002 Sep;17(9):2474-9. doi: 10.1093/humrep/17.9.2474.
Few adult environmental or behavioural factors have been consistently associated with age at menopause. The peak number of follicles attained in utero or lost before ovulation begins may be more important. This study investigates whether birthweight, childhood body size, having been breastfed and early socioeconomic circumstances are associated with age at menopause.
Menopausal status and risk factor information have been collected prospectively from 1572 British women followed up since their birth in 1946, so far until 53 years. Cox's regression models were used to investigate the relationships between early life factors and rate of menopause.
Age at menopause varied by duration of breastfeeding, weight at age 2 years, childhood socioeconomic status, but not birthweight. In a multiple regression model, women of low weight at 2 years had an earlier menopause [hazard ratio (HR) = 0.75 for highest versus lowest quarter: 95% confidence interval (CI) 0.54-1.02] and those who had been breastfed had a later menopause (HR = 0.69 for vertical line 7 months versus never breastfed: 95% CI 0.51-0.92) than others. The influence of socioeconomic status was attenuated.
Early life influences may influence ovarian ageing, highlighting the importance of investigating factors from across the life course.
很少有成人环境或行为因素与绝经年龄持续相关。子宫内达到的卵泡峰值数量或排卵开始前丢失的卵泡数量可能更为重要。本研究调查出生体重、儿童期体型、是否母乳喂养以及早期社会经济状况是否与绝经年龄相关。
自1946年出生以来，前瞻性收集了1572名英国女性的绝经状态和危险因素信息，随访至今达53年。采用Cox回归模型研究早期生活因素与绝经率之间的关系。
绝经年龄因母乳喂养持续时间、2岁时体重、儿童期社会经济状况而异，但与出生体重无关。在多元回归模型中，2岁时体重低的女性绝经较早（最高四分位数与最低四分位数相比，风险比[HR]=0.75：95%置信区间[CI]0.54-1.02），母乳喂养的女性绝经较晚（母乳喂养7个月与从未母乳喂养相比，HR=0.69：95%CI0.51-0.92）。社会经济状况的影响减弱。
早期生活影响可能影响卵巢衰老，突出了研究整个生命历程中各种因素的重要性。
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