Midgette A S, Baron J A
Veterans Affairs Medical Center, White River Junction, Vermont.
Epidemiology. 1990 Nov;1(6):474-80. doi: 10.1097/00001648-199011000-00010.
We reviewed published studies on the association of age at natural menopause and cigarette smoking. All demonstrated an earlier median or mean age of menopause among smokers; for current smokers vs noncurrent smokers the difference ranged from 0.8 to 1.7 years. For studies that presented suitable data, we computed prevalence odds ratios of menopause for current smokers vs never-smokers, current smokers vs noncurrent smokers, and former smokers vs never-smokers. The Mantel-Haenzel summary odds ratios and 95% confidence intervals for these contrasts were: 1.9 (1.7-2.2), 1.7 (1.5-1.9), and 1.3 (1.0-1.7). Studies that presented data on amount of cigarettes smoked per day demonstrated "dose-response" trends when analyzed using the Mantel-Haenszel extension. The consistency of results across studies, the persistence of the effect when age and other covariates were considered, and the dose-response relation all support the hypothesis that smoking increases the risk of early menopause.
我们回顾了已发表的关于自然绝经年龄与吸烟之间关联的研究。所有研究均表明吸烟者的绝经年龄中位数或平均数更早；当前吸烟者与非当前吸烟者相比，差异范围为0.8至1.7岁。对于提供了合适数据的研究，我们计算了当前吸烟者与从不吸烟者、当前吸烟者与非当前吸烟者以及既往吸烟者与从不吸烟者之间绝经的患病率比值比。这些对比的Mantel-Haenzel汇总比值比及95%置信区间分别为：1.9（1.7 - 2.2）、1.7（1.5 - 1.9）和1.3（1.0 - 1.7）。那些提供了每日吸烟量数据的研究在使用Mantel-Haenszel扩展法分析时呈现出“剂量反应”趋势。各项研究结果的一致性、在考虑年龄及其他协变量时效应的持续性以及剂量反应关系均支持吸烟会增加早绝经风险这一假说。
