Department of Epidemiology Graduate School of Public Health, Epidemiology Data Center, University of Pittsburgh, 4420 Bayard St., Suite 600, Pittsburgh, PA 15260, USA.
Maturitas. 2020 Nov;141:33-38. doi: 10.1016/j.maturitas.2020.06.007. Epub 2020 Jun 20.
Earlier menopause onset has been linked to a greater risk of cardiovascular disease. Both menopause onset and cardiovascular disease risk vary by geographical region, race/ethnicity and socioeconomic status. As such, it is plausible to hypothesize that these factors may influence the association of menopause onset and cardiovascular disease risk. Taking a global approach, this narrative review focuses on how geographic, racial/ethnic and socioeconomic factors might influence menopause onset, mainly natural menopause, and possibly its association with cardiovascular disease risk. The contribution of genetic factors to menopause onset variation is also summarized. A clear gap in the literature has been identified. Several meta-analyses have assessed the question of whether menopause onset is related to cardiovascular disease risk by combining large populations of diverse racial/ethnic backgrounds and socioeconomic status across wide geographical regions. None of these analyses adequately assessed how these factors might modify the association of menopause onset and cardiovascular disease risk. Testing such a question requires the study of a large group of women of diverse racial/ethnic backgrounds across different geographical locations with good documentation of their socioeconomic status, clinical and environmental factors. The increasing evidence supporting age at menopause onset as a marker of overall health calls for worldwide efforts to implement a standardized approach to define age at menopause in both the clinical and the research fields.
绝经年龄提前与心血管疾病风险增加有关。绝经年龄和心血管疾病风险因地理位置、种族/民族和社会经济地位而异。因此，可以假设这些因素可能会影响绝经年龄与心血管疾病风险之间的关联。本综述采用全球方法，重点关注地理、种族/民族和社会经济因素如何影响绝经年龄（主要是自然绝经），并可能影响其与心血管疾病风险的关联。还总结了遗传因素对绝经年龄变化的影响。文献中明显存在差距。几项荟萃分析通过结合不同种族/民族背景和广泛地理区域的不同社会经济地位的大量人群，评估了绝经年龄与心血管疾病风险之间的关系。这些分析都没有充分评估这些因素如何改变绝经年龄与心血管疾病风险之间的关联。要检验这样的问题，需要在不同地理位置研究一大群不同种族/民族背景的女性，详细记录她们的社会经济地位、临床和环境因素。越来越多的证据支持绝经年龄作为整体健康指标，这呼吁全世界努力在临床和研究领域实施一种标准化的方法来定义绝经年龄。
