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伊朗人群中卵巢早衰的流行情况及其决定因素:德黑兰血脂和血糖研究。

Prevalence of premature ovarian insufficiency and its determinants in Iranian populations: Tehran lipid and glucose study.

机构信息

Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, No 24, Shahid Arabi St., Yaman Ave, Velenjak, P.O.Box, 19395-4763, Tehran, Iran.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

BMC Womens Health. 2021 Feb 23;21(1):79. doi: 10.1186/s12905-021-01228-1.

Abstract

BACKGROUND

Premature ovarian insufficiency (POI) considered as a concerning health issue for women of reproductive age. In this study we aim to estimate the prevalence of POI and assessing the influential factors.

METHODS

Data was obtained from Tehran lipid and glucose study (TLGS). All eligible post-menarcheal female participants of the TLGS, ages 20-65, were recruited (n = 6521). Participants were followed for the event of menopause, and age at menopause was recorded. Kaplan Meier analysis was applied to estimate mean and median for age at menopause. Weibull accelerated failure time survival regression model (AFT), was applied to assess influential determinants of POI. Conditional probability approach was used to provide estimation for prevalence of POI.

RESULTS

In this population-based study, the prevalence of POI (menopause age < 40 years) and early menopause (menopause age < 45 years) were estimated 3.5% and 24.6%, respectively. AFT model showed that in comparison to normal weight women, time to menopause was decreased by - 0.09 year (95% CI - 0.27, - 0.01, p = 0.023) and - 0.03 year (95% CI - 0.05, - 0.02, p = 0.000) in underweight and overweight women, respectively. Moreover, time to natural menopause was increased by 0.12 year (95% CI 0.07 to 0.17, p = 0.000) in women used oral contraceptives for > 6 months.

CONCLUSION

About one quartile of Iranian women experienced menopause at an age less than 45, especially the non-normal weight ones; this high prevalence is a critical public health concerns that needs to be addressed by health policy makers.

摘要

背景

卵巢早衰(POI)被认为是育龄妇女关注的健康问题。本研究旨在评估 POI 的患病率,并评估其影响因素。

方法

数据来自德黑兰血脂和血糖研究(TLGS)。所有符合条件的 TLGS 绝经后女性参与者,年龄在 20-65 岁之间(n=6521)被招募。对参与者进行随访以观察绝经事件,并记录绝经年龄。应用 Kaplan-Meier 分析估计绝经年龄的平均值和中位数。应用 Weibull 加速失效时间生存回归模型(AFT)评估 POI 的影响因素。应用条件概率方法提供 POI 的患病率估计。

结果

在这项基于人群的研究中,POI(绝经年龄<40 岁)和早绝经(绝经年龄<45 岁)的患病率分别估计为 3.5%和 24.6%。AFT 模型显示,与正常体重女性相比,超重和体重不足女性的绝经时间分别提前了 -0.09 年(95%CI-0.27,-0.01,p=0.023)和-0.03 年(95%CI-0.05,-0.02,p=0.000)。此外,口服避孕药使用>6 个月的女性自然绝经时间增加了 0.12 年(95%CI0.07 至 0.17,p=0.000)。

结论

约四分之一的伊朗女性在 45 岁之前绝经,尤其是非正常体重的女性;这种高患病率是一个关键的公共卫生问题,需要卫生政策制定者来解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdcf/7903639/1a3c269eda59/12905_2021_1228_Fig1_HTML.jpg

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