Banas Tomasz, Hajdyla-Banas Iwona, Pitynski Kazimierz, Niewegłowska Dorota, Juszczyk Grzegorz, Ludwin Artur, Knafel Anna, Ludwin Inga
1Department of Gynecology and Oncology, Jagiellonian University Medical College, Krakow, Poland2Center of Rheumatology, Immunology and Rehabilitation, Dietl Specialistic Hospital, Krakow, Poland3Department of Public Health, Medical University of Warsaw, Warsaw, Poland4Department of Gynecological Endocrinology, Jagiellonian University Medical College, Krakow, Poland.
Menopause. 2016 Oct;23(10):1130-8. doi: 10.1097/GME.0000000000000674.
The aim of the study was to compare the natural menopause ages of healthy women with those of women with methotrexate (MTX)-treated rheumatoid arthritis (RA), and to specifically assess the effect of disease onset and activity and the use of MTX on the age of the last menstruation.
We performed a retrospective review of medical records to identify the ages at which menopause occurred in women with premenopausal RA treated with MTX and in women with postmenopausal onset, irrespective of therapy. Natural menopause ages were also compared between participants with and without RA.
Women with premenopausal onset of RA underwent menopause at a significantly younger age than did healthy women (P < 0.001) or those with postmenopausal disease onset (P = 0.001). Menopause also occurred at younger ages in participants with postmenopausal disease onset than in healthy controls (P = 0.012). The study suggested that menopause age was positively correlated with the age at which RA was diagnosed (R = 0.51; P < 0.001) in women with premenopausal RA onset, but was independent of the participant's age at menarche, number of pregnancies, or MTX therapy. Participants with RA onset at ≤ 35 years of age had a ninefold higher risk of premature menopause (P = 0.008).
The age at which menopause occurs in a patient with RA depends on the patient's age at the time of disease onset and its duration, but is not influenced by MTX treatment.
本研究旨在比较健康女性与接受甲氨蝶呤（MTX）治疗的类风湿关节炎（RA）女性的自然绝经年龄，并具体评估疾病发作和活动情况以及MTX的使用对末次月经年龄的影响。
我们对病历进行了回顾性分析，以确定接受MTX治疗的绝经前RA女性以及绝经后发病女性（无论治疗情况如何）的绝经年龄。还比较了有RA和无RA参与者的自然绝经年龄。
绝经前发病的RA女性绝经年龄显著低于健康女性（P<0.001）或绝经后发病的女性（P=0.001）。绝经后发病的参与者绝经年龄也低于健康对照者（P=0.012）。研究表明，绝经前发病的RA女性绝经年龄与RA诊断年龄呈正相关（R=0.51；P<0.001），但与初潮年龄、妊娠次数或MTX治疗无关。发病年龄≤35岁的RA参与者过早绝经风险高9倍（P=0.008）。
RA患者的绝经年龄取决于疾病发作时的年龄及其病程，但不受MTX治疗影响。
