生育期内暴露于雌激素的时间、初潮年龄和绝经年龄与心血管疾病事件、全因和心血管死亡率的风险：系统评价和荟萃分析。

Duration of estrogen exposure during reproductive years, age at menarche and age at menopause, and risk of cardiovascular disease events, all-cause and cardiovascular mortality: a systematic review and meta-analysis.

机构信息

School of Public Health, The University of Queensland, Brisbane, Australia.

出版信息

BJOG. 2021 Apr;128(5):809-821. doi: 10.1111/1471-0528.16524. Epub 2020 Nov 5.

DOI:10.1111/1471-0528.16524

PMID:32965759

Abstract

BACKGROUND

Little is known about the estrogen exposure measurement and mutual effect of age at menarche and age at menopause in the risk of cardiovascular disease (CVD) events.

OBJECTIVES

To evaluate estrogen exposure measurement and describe mutual effect of age at menarche and age at menopause in the risk of CVD events.

SEARCH STRATEGY

Systematic review of literature in PubMed, Embase and Web of Science for studies published up to 28 June 2020.

SELECTION CRITERIA

Observational studies related to estrogen exposure measurement, including mutual effect of age at menarche and age at menopause and risk of CVD events.

DATA COLLECTION AND ANALYSIS

Synthesis of evidence was conducted by reviewing individual estimates, followed by meta-analysis. The study received no external funding.

MAIN RESULTS

A total of 75 studies were included in synthesis of evidence, of which 17 studies were included in meta-analysis. Reproductive lifespan (age at menopause - age at menarche), endogenous estrogen exposure and total estrogen exposure were used for estrogen exposure measurement. Reproductive lifespan was by far the most commonly used method for estrogen exposure measurement. A shorter reproductive lifespan was associated with a higher risk of CVD events; the pooled relative risk (95% CI) was 1.31 (1.25-1.36) for stroke events. Robust epidemiological studies with measurement of estrogen exposure and associated health risk would strengthen the evidence.

CONCLUSIONS

Reproductive lifespan was the most commonly used method for estrogen exposure measurement in epidemiological studies. A shorter reproductive lifespan was associated with a higher risk of CVD events, particularly stroke.

TWEETABLE ABSTRACT

A systematic review and meta-analysis found that women with a shorter reproductive lifespan have a higher risk of stroke events.

摘要

背景

关于绝经期和初潮年龄与心血管疾病 (CVD) 事件风险之间的雌激素暴露测量和相互作用知之甚少。

目的

评估雌激素暴露测量方法，并描述绝经期和初潮年龄与 CVD 事件风险之间的相互作用。

检索策略

系统检索 PubMed、Embase 和 Web of Science 中截至 2020 年 6 月 28 日发表的相关文献。

选择标准

与雌激素暴露测量相关的观察性研究，包括绝经期和初潮年龄的相互作用与 CVD 事件风险。

数据收集和分析

通过回顾个体估计值进行证据综合，然后进行荟萃分析。本研究没有接受外部资金。

主要结果

共有 75 项研究纳入证据综合，其中 17 项研究纳入荟萃分析。生殖寿命（绝经年龄-初潮年龄）、内源性雌激素暴露和总雌激素暴露用于雌激素暴露测量。生殖寿命是迄今为止最常用的雌激素暴露测量方法。较短的生殖寿命与 CVD 事件风险增加相关；中风事件的汇总相对风险（95%CI）为 1.31（1.25-1.36）。具有雌激素暴露测量和相关健康风险评估的强有力的流行病学研究将增强证据。