Parente Raphael C, Faerstein Eduardo, Celeste Roger Keller, Werneck Guilherme L
Department of Epidemiology, Institute of Social Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Maturitas. 2008 Dec 20;61(4):287-98. doi: 10.1016/j.maturitas.2008.09.021. Epub 2008 Nov 18.
Increasing life expectancy has made it ever more important to study the factors that influence the age at the menopause, given that when it is reached outside of the normal range, it is associated with increased risk of osteoporosis and cardiovascular diseases, among other conditions. Among the factors studied in relation to early menopause, smoking is prominent. Destruction of the ovarian follicles is one of the mechanisms postulated for this effect. The aim of this study was to review and describe the associations between age at the menopause and the habit of smoking, its duration and its intensity.
A systematic review of the literature indexed in the MEDLINE and LILACS databases was conducted, without restriction on publication date. After initially identifying 1325 articles and preselecting 161 articles for consideration of their complete texts, 96 articles reporting on the results from 109 studies were selected for analysis.
A great majority of the studies reported an association between the habit of smoking and early menopause, but there was no clear evidence that the duration of smoking and quantity of cigarettes smoked had any association with age at the natural menopause.
Additional studies are needed, preferably of prospective nature and with a large number of women, in order to deepen the knowledge of the effects of various aspects of smoking on age at the menopause. Experimental studies on animals may also contribute towards clarifying the physiopathological mechanisms through which smoking influences age at the menopause.
鉴于预期寿命的延长，研究影响绝经年龄的因素变得愈发重要，因为绝经年龄超出正常范围时，会增加患骨质疏松症和心血管疾病等疾病的风险。在与早绝经相关的研究因素中，吸烟较为突出。卵巢卵泡的破坏是推测的该效应机制之一。本研究的目的是回顾和描述绝经年龄与吸烟习惯、吸烟持续时间及其强度之间的关联。
对MEDLINE和LILACS数据库中索引的文献进行系统综述，不受出版日期限制。在最初识别出1325篇文章并预选161篇文章以供考虑其全文后，选择了96篇报告109项研究结果的文章进行分析。
绝大多数研究报告了吸烟习惯与早绝经之间的关联，但没有明确证据表明吸烟持续时间和吸烟量与自然绝经年龄有任何关联。
需要进行更多研究，最好是前瞻性研究且涉及大量女性，以加深对吸烟各方面对绝经年龄影响的认识。动物实验研究也可能有助于阐明吸烟影响绝经年龄的生理病理机制。
