Department of Public Health, University of Oxford, Oxford, United Kingdom.
Fertil Steril. 2012 Sep;98(3):702-712.e6. doi: 10.1016/j.fertnstert.2012.05.035. Epub 2012 Jun 22.
To review published studies evaluating early menarche and the risk of endometriosis.
Systematic review and meta-analysis of case-control studies.
None.
PATIENT(S): Eighteen case-control studies of age at menarche and risk of endometriosis including 3,805 women with endometriosis and 9,526 controls.
INTERVENTION(S): None.
MAIN OUTCOME MEASURE(S): Medline and Embase databases were searched from 1980 to 2011 to locate relevant studies. Results of primary studies were expressed as effect sizes of the difference in mean age at menarche of women with and without endometriosis. Effect sizes were used in random effects meta-analysis.
RESULT(S): Eighteen of 45 articles retrieved met the inclusion criteria. The pooled effect size in meta-analysis was 0.10 (95% confidence interval -0.01-0.21), and not significantly different from zero (no effect). Results were influenced by substantial heterogeneity between studies (I(2) = 72.5%), which was eliminated by restricting meta-analysis to studies with more rigorous control of confounders; this increased the pooled effect size to 0.15 (95% confidence interval 0.08-0.22), which was significantly different from zero. This represents a probability of 55% that a woman with endometriosis had earlier menarche than one without endometriosis if both were randomly chosen from a population.
CONCLUSION(S): There is a small increased risk of endometriosis with early menarche. The potential for disease misclassification in primary studies suggests that this risk could be higher.
综述评估初潮早与子宫内膜异位症风险的已发表研究。
病例对照研究的系统评价和荟萃分析。
无。
18 项关于初潮年龄与子宫内膜异位症风险的病例对照研究，包括 3805 例子宫内膜异位症患者和 9526 例对照。
无。
1980 年至 2011 年，通过 Medline 和 Embase 数据库检索相关研究。主要研究结果表示为有和无子宫内膜异位症的女性初潮年龄差异的效应量。采用随机效应荟萃分析进行分析。
45 篇文章中检索到的 18 篇符合纳入标准。荟萃分析的汇总效应量为 0.10（95%置信区间-0.01 至 0.21），与零值（无影响）无显著差异。研究之间存在明显的异质性（I²=72.5%），限制荟萃分析仅纳入对混杂因素控制更严格的研究后，该异质性得以消除，汇总效应量增加至 0.15（95%置信区间 0.08 至 0.22），与零值有显著差异。这表示如果从人群中随机选择患有子宫内膜异位症的女性和不患有子宫内膜异位症的女性，前者初潮早的概率为 55%。
初潮早与子宫内膜异位症风险增加有关。原始研究中疾病分类错误的可能性表明，这种风险可能更高。
