Lieberoth Sofie, Gade Elisabeth Juul, Brok Jesper, Backer Vibeke, Thomsen Simon Francis
Department of Respiratory Medicine, Bispebjerg Hospital , Copenhagen , Denmark .
J Asthma. 2014 Aug;51(6):559-65. doi: 10.3109/02770903.2014.903966. Epub 2014 Apr 7.
Several studies have suggested a relationship between the age at menarche and risk of asthma development.
To conduct a systematic review and meta-analysis of the relationship between the age at menarche and the risk of asthma.
This systematic review and meta-analysis was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A pre specified literature search strategy was used to identify studies of potential relevance and independent reviews were carried out by two authors. Raw data was pooled using the software package RevMan to calculate summary odds ratios. The risk of publication bias was assessed graphically by using a funnel plot and the robustness of the overall estimate obtained was assessed by using sensitivity analyses.
The searches identified 61 potentially relevant articles of which seven articles, with a total of 22,859 subjects, matched the inclusion criteria for the meta-analysis. Pooling of the seven studies showed that girls with early menarche (<12 years) had an increased risk of asthma relative to girls with late menarche; random effects odds ratio = 1.37 (1.15-1.64), (p = 0.0005). Substantial heterogeneity was revealed (I(2) = 55%). Sensitivity analysis showed that the risk estimate was not markedly changed when excluding any of the studies. The funnel plot did not indicate publication bias.
Early menarche appears to be associated with increased risk of asthma. Hormonal, immunological, genetic and environmental factors may act in a developmental context to explain this relationship. Future studies are warranted to further determine the mechanisms responsible for this observation.
多项研究表明初潮年龄与哮喘发病风险之间存在关联。
对初潮年龄与哮喘风险之间的关系进行系统评价和荟萃分析。
本系统评价和荟萃分析按照系统评价和荟萃分析的首选报告项目（PRISMA）进行。采用预先指定的文献检索策略来识别潜在相关研究，由两位作者进行独立评审。使用RevMan软件包汇总原始数据以计算汇总比值比。通过漏斗图以图形方式评估发表偏倚的风险，并使用敏感性分析评估所获得的总体估计的稳健性。
检索到61篇潜在相关文章，其中7篇文章，共22859名受试者，符合荟萃分析的纳入标准。对这7项研究的汇总分析表明，初潮早（<12岁）的女孩相对于初潮晚的女孩患哮喘的风险增加；随机效应比值比=1.37（1.15 - 1.64），（p = 0.0005）。显示出显著的异质性（I² = 55%）。敏感性分析表明，排除任何一项研究时，风险估计没有明显变化。漏斗图未显示发表偏倚。
初潮早似乎与哮喘风险增加有关。激素、免疫、遗传和环境因素可能在发育背景下起作用来解释这种关系。未来有必要进行进一步研究以确定导致这一观察结果的机制。
