Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Department of Emergency, Affiliated Nanping First Hospital, Fujian Medical University, Nanping, Fujian, China.
Biomed Res Int. 2021 Mar 15;2021:6636856. doi: 10.1155/2021/6636856. eCollection 2021.
The aim of this meta-analysis was to comprehensively evaluate the association of early age at natural menopause with the risk for all-cause and cardiovascular mortality.
Literature retrieval was done on August 4, 2020. Article selection and data extraction were completed independently and in duplicate. Early age at natural menopause was grouped into premature menopause (<40 years), early menopause (40-44 years), and relatively early menopause (45-49 years). Effect-size estimates are summarized as hazard ratio (HR) or relative risk (RR) with 95% confidence interval (CI).
Sixteen articles involving 321,233 women were meta-analyzed. Overall analyses revealed a statistically significant association of early age at natural menopause with all-cause mortality risk (HR = 1.08, 95% CI: 1.03 to 1.14, = 0.002; RR = 1.05, 95% CI 1.01 to 1.08, = 0.005), but not with cardiovascular mortality risk. In dose-response analyses, the association with all-cause mortality was significant for premature menopause with (HR = 1.10; 95% CI: 1.01 to 1.21; = 0.034) and without (RR = 1.34; 95% CI: 1.08 to 1.66; = 0.007) considering follow-up intervals. As for cardiovascular mortality, marginal significance was noted for premature menopause after considering follow-up intervals (HR = 1.09; 95% CI: 1.00-1.19; = 0.045). Subgroup analyses indicated that gender, country, and follow-up periods were possible causes of heterogeneity. There was an overall low probability of publication bias.
Our findings indicate that premature menopause is a promising independent risk factor for both all-cause and cardiovascular mortality.
本荟萃分析的目的是全面评估自然绝经年龄较早与全因和心血管死亡率风险的相关性。
文献检索于 2020 年 8 月 4 日进行。文章选择和数据提取由两人独立完成。自然绝经年龄较早被分为绝经提前（<40 岁）、绝经较早（40-44 岁）和绝经相对较早（45-49 岁）。效应大小估计以危险比（HR）或相对风险（RR）和 95%置信区间（CI）表示。
共纳入 16 项涉及 321233 名女性的研究进行荟萃分析。总体分析显示，自然绝经年龄较早与全因死亡率风险呈显著相关（HR=1.08，95%CI：1.03 至 1.14， = 0.002；RR=1.05，95%CI 1.01 至 1.08， = 0.005），但与心血管死亡率风险无关。在剂量反应分析中，对于绝经提前，与全因死亡率相关的关联在考虑随访间隔时有统计学意义（HR=1.10；95%CI：1.01 至 1.21； = 0.034），而无统计学意义（RR=1.34；95%CI：1.08 至 1.66； = 0.007）。对于心血管死亡率，在考虑随访间隔后，绝经提前的边缘显著（HR=1.09；95%CI：1.00 至 1.19； = 0.045）。亚组分析表明，性别、国家和随访时间可能是异质性的原因。总体上，出版偏倚的可能性较低。
我们的研究结果表明，绝经提前是全因和心血管死亡率的一个有前途的独立危险因素。
