Soleimani Azam, Pourmoghaddas Ali, Sadeghi Masoumeh, Roohafza Hamidreza, Talaei Mohammad, Dianatkhah Minoo, Oveisgharan Shahram, Soleimani Maryam, Sarrafzadegan Nizal
1 Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan, Iran .
2 Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences , Isfahan, Iran .
Metab Syndr Relat Disord. 2018 Apr;16(3):127-134. doi: 10.1089/met.2017.0096. Epub 2018 Feb 13.
There is still a controversy about the causal relationship between menopause status and cardiovascular disease (CVD). The present study aimed to evaluate whether premature menopause would predict higher risk and lower the age of CVD occurrence and how this differs in women with metabolic syndrome (MetS).
Using a population-based Isfahan Cohort Study (ICS), 1154 postmenopause women were followed up from 2001 to 2013 for any CVD occurrence. Cox proportional hazards regression analyses were used to estimate the association between menopause age of (≤45, 46-50, 51-55, ≥56 years) and CVD incidence. The menopause age group of 46-50 years was considered as reference group.
During 12 years follow-up, 235 CV events were recorded. The mean age of menopause (±standard deviation) was 48.06 ± 5.48 years. The age at menopause was not predictive of total CV events, in women with and without MetS. In women without MetS, a trend with increasing incidence of stroke was observed at menopause age of ≤45 years (age adjusted hazard ratio: 4.84, 95% confidence interval: 0.99-23.5, P = 0.05). Women with menopause age of ≤45 years suffered from CV events, 5.7 years earlier than women with menopause age of ≥56 years (P = 0.11); this difference was 5.3 years in women with MetS (P = 0.4).
This study showed that younger age at menopause is not predictive of the occurrence of CV events. It also revealed that age at menopause is not associated with earlier CV events in postmenopause women, with and without MetS.
绝经状态与心血管疾病（CVD）之间的因果关系仍存在争议。本研究旨在评估过早绝经是否会预示更高的风险并降低CVD发生的年龄，以及在患有代谢综合征（MetS）的女性中情况有何不同。
利用基于人群的伊斯法罕队列研究（ICS），对1154名绝经后女性从2001年至2013年进行随访，观察是否发生任何CVD。采用Cox比例风险回归分析来估计绝经年龄（≤45岁、46 - 50岁、51 - 55岁、≥56岁）与CVD发病率之间的关联。将46 - 50岁的绝经年龄组作为参照组。
在12年的随访期间，记录了235例心血管事件。绝经的平均年龄（±标准差）为48.06±5.48岁。绝经年龄并不能预测有或没有MetS的女性发生总的心血管事件。在没有MetS的女性中，绝经年龄≤45岁时观察到中风发病率有上升趋势（年龄调整风险比：4.84，95%置信区间：0.99 - 23.5，P = 0.05）。绝经年龄≤45岁的女性发生心血管事件的时间比绝经年龄≥56岁的女性早5.7年（P = 0.11）；在患有MetS的女性中，这一差异为5.3年（P = 0.4）。
本研究表明，绝经年龄较小并不能预测心血管事件的发生。研究还表明，绝经年龄与有或没有MetS的绝经后女性较早发生心血管事件无关。
