Department of Obstetrics and Gynecology, Haga Red Cross Hospital, Tochigi 321-4306, Japan.
Menopause. 2010 May-Jun;17(3):506-10. doi: 10.1097/gme.0b013e3181c7dd41.
: Few epidemiological studies have examined the relationship between age at menopause and stroke incidence, and none have done so in Japanese women. Here, we investigated the relationship between age at menopause and stroke incidence in a large group of Japanese women.
: The study participants were 4,790 postmenopausal women aged 36 to 89 years enrolled in the Jichi Medical School Cohort Study, a population-based prospective study. Baseline data were obtained by questionnaire and health checkups between April 1992 and July 1995 in 12 rural areas in Japan. The incidence of all strokes and stroke subtypes was monitored.
: Mean (SD) participant age was 61.0 (6.7) years, and mean (SD) age at menopause was 48.3 (4.8) years. A total of 185 strokes were observed during a mean follow-up of 10.8 years. On adjustment for age, systolic blood pressure, total cholesterol, body mass index, smoking habits, and alcohol drinking habits, hazard ratios (95% CIs) of stroke for women who underwent menopause before age 40 years, at 40 to 44 years, at 45 to 49 years, and at 55 years or after relative to those who underwent menopause at age 50 to 54 years were 1.56 (0.78-3.12), 1.59 (1.00-2.51), 1.28 (0.92-1.78), and 0.83 (0.38-1.81), respectively. However, hazard ratios (95% CI) of cerebral infarction for women who underwent menopause before age 40 years, at 40 to 44 years, at 45 to 49 years, and at 55 years or after relative to those who underwent menopause at age 50 to 54 years were 2.57 (1.20-5.49), 1.49 (0.80-2.78), 1.06 (0.67-1.68), and 1.08 (0.43-2.74), respectively.
: Our data suggest that Japanese women who undergo menopause before age 40 years are at an increased risk of cerebral infarction. Premature menopause should be considered an indicator of the need for more aggressive medical intervention aimed at the prevention of cerebral infarction.
很少有流行病学研究调查过绝经年龄与中风发病率之间的关系，也没有在日本女性中进行过此类研究。在这里，我们调查了一大群日本女性的绝经年龄与中风发病率之间的关系。
研究参与者为 4790 名年龄在 36 至 89 岁之间的绝经后女性，她们参加了基于人群的前瞻性 Jichi 医科大学队列研究。1992 年 4 月至 1995 年 7 月，在日本 12 个农村地区通过问卷调查和健康检查获得基线数据。监测所有中风和中风亚型的发病率。
平均（SD）参与者年龄为 61.0（6.7）岁，平均（SD）绝经年龄为 48.3（4.8）岁。在平均 10.8 年的随访期间，共观察到 185 例中风。在校正年龄、收缩压、总胆固醇、体重指数、吸烟习惯和饮酒习惯后，40 岁前、40-44 岁、45-49 岁和 55 岁及以上绝经的女性中风的风险比（95%CI）分别为 1.56（0.78-3.12）、1.59（1.00-2.51）、1.28（0.92-1.78）和 0.83（0.38-1.81）。然而，40 岁前、40-44 岁、45-49 岁和 55 岁及以上绝经的女性脑梗死的风险比（95%CI）分别为 2.57（1.20-5.49）、1.49（0.80-2.78）、1.06（0.67-1.68）和 1.08（0.43-2.74）。
我们的数据表明，40 岁前绝经的日本女性患脑梗死的风险增加。过早绝经应被视为需要更积极医疗干预以预防脑梗死的指标。
