Center for Research on Women's and Children's Health, Public Health Institute, University of California San Francisco, San Francisco, California 94115, USA.
J Clin Endocrinol Metab. 2011 Jan;96(1):E114-8. doi: 10.1210/jc.2010-1709. Epub 2010 Oct 27.
Polycystic ovary syndrome, the most common cause of irregular menstrual cycles, is associated with an adverse cardiovascular risk profile. However, there are limited prospective studies confirming the link between polycystic ovary syndrome and cardiovascular mortality.
We studied 15,005 pregnant women recruited from the Kaiser Foundation Health Plan in California between 1959 and 1966. The menstrual cycle pattern was assessed at baseline according to self-report, physician report, and medical record abstraction. Participants were matched to California Vital Status files annually until 2007 to identify deaths due to overall cardiovascular disease (CVD) and subsets of coronary heart disease (CHD) and cerebrovascular disease based on International Classification of Diseases codes. Cox proportional hazards models were used to estimate the association between irregular cycles and cardiovascular mortality. Missing covariate data were multiply imputated using standard methods.
During 456,298.5 person-years of follow-up, there were 666 CVD deaths, including 301 CHD deaths and 149 cerebrovascular deaths. Compared with women with regular cycles, women with irregular cycles had an increased risk for CHD mortality [age adjusted hazards ratio (HR) 1.42, 95% confidence interval (CI) 1.03-1.94]; however, the association was not statistically significant after adjustment for body mass index (adjusted HR 1.35, 95% CI 0.98-1.85). There was a nonsignificant increase in CVD mortality (age adjusted HR 1.21, 95% CI 0.97-1.52) but not cerebrovascular mortality (age adjusted HR 0.85, 95% CI 0.49-1.47).
In this large prospective cohort of pregnant women, we found an increase in age-adjusted risk for CHD mortality in women with irregular menstrual cycles. This risk was attenuated after adjustment for body mass index.
多囊卵巢综合征是导致月经周期不规律的最常见原因，与不良心血管风险状况相关。然而，目前仅有少数前瞻性研究证实多囊卵巢综合征与心血管死亡率之间存在关联。
我们研究了 1959 年至 1966 年期间从加利福尼亚州 Kaiser 基金会健康计划中招募的 15005 名孕妇。根据自我报告、医生报告和病历摘要，在基线时评估月经周期模式。参与者每年与加利福尼亚州生命状况档案相匹配，直到 2007 年，以根据国际疾病分类代码确定整体心血管疾病（CVD）和冠心病（CHD）及脑血管疾病亚组的死亡人数。使用 Cox 比例风险模型估计不规律周期与心血管死亡率之间的关联。使用标准方法对缺失协变量数据进行多重插补。
在 456298.5 人年的随访期间，共有 666 例 CVD 死亡，包括 301 例 CHD 死亡和 149 例脑血管死亡。与月经周期规律的女性相比，月经周期不规律的女性 CHD 死亡率增加[年龄调整后的危险比（HR）1.42，95%置信区间（CI）1.03-1.94]；然而，在调整体重指数后，这种关联无统计学意义（调整后的 HR 1.35，95%CI 0.98-1.85）。CVD 死亡率有增加的趋势（年龄调整后的 HR 1.21，95%CI 0.97-1.52），但脑血管死亡率无明显增加（年龄调整后的 HR 0.85，95%CI 0.49-1.47）。
在这项大型前瞻性孕妇队列研究中，我们发现月经周期不规律的女性 CHD 死亡率的年龄调整风险增加。这种风险在调整体重指数后减弱。
