Nielsen Nete Munk, Harpsøe Maria, Simonsen Jacob, Stenager Egon, Magyari Melinda, Koch-Henriksen Nils, Baker Jennifer L, Hjalgrim Henrik, Frisch Morten, Bager Peter
Department of Epidemiology Research, Statens Serum Institut, Artillerivej 5, 2300 Copenhagen, Denmark.
Institute of Regional Health Research, University of Southern Denmark, DK-5000, Odense, Denmark.
Am J Epidemiol. 2017 Apr 15;185(8):712-719. doi: 10.1093/aje/kww160.
Few studies have addressed the possible association between age at menarche and multiple sclerosis (MS), and results are conflicting. We studied this issue in a large prospective cohort study. The study cohort comprised 77,330 women included in the Danish National Birth Cohort (1996-2002). Information on menarcheal age was ascertained at the first interview, which took place in the 16th week of pregnancy. Women were followed for MS from the first interview to December 31, 2011. Associations between age at menarche and risk of MS were evaluated with hazard ratios and 95% confidence intervals using Cox proportional hazards regression models. Overall, 226 women developed MS during an average follow-up period of 11.7 years. Age at menarche among women with MS was generally lower than that among women without MS (Wilcoxon rank-sum test; P = 0.002). We observed an inverse association between age at menarche and MS risk. For each 1-year increase in age at menarche, risk of MS was reduced by 13% (hazard ratio = 0.87, 95% confidence interval: 0.79, 0.96). Early age at menarche appears to be associated with an increased risk of MS. The mechanisms behind this association remain to be established.
很少有研究探讨初潮年龄与多发性硬化症（MS）之间可能存在的关联，且研究结果相互矛盾。我们在一项大型前瞻性队列研究中对这一问题进行了研究。研究队列包括丹麦国家出生队列（1996 - 2002年）中的77330名女性。初潮年龄信息在首次访谈时确定，该访谈在怀孕第16周进行。从首次访谈至2011年12月31日对女性进行MS随访。使用Cox比例风险回归模型，通过风险比和95%置信区间评估初潮年龄与MS风险之间的关联。总体而言，在平均11.7年的随访期内，有226名女性患上了MS。患MS女性的初潮年龄普遍低于未患MS的女性（Wilcoxon秩和检验；P = 0.002）。我们观察到初潮年龄与MS风险之间存在负相关。初潮年龄每增加1岁，MS风险降低13%（风险比 = 0.87，95%置信区间：0.79，0.96）。初潮年龄早似乎与MS风险增加有关。这种关联背后的机制仍有待确定。
