Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Women Health. 2021 Nov-Dec;61(10):917-936. doi: 10.1080/03630242.2021.1992067. Epub 2021 Nov 28.
Despite several existing studies on the age at natural menopause (ANM) and its related factors, epidemiologic data on the associations between chronic diseases and ANM are scarce with conflicting and inconclusive results. The aim of this systematic review was to summarize the results of the studies investigating the association between chronic disease and ANM. PubMed, Scopus, and Web of Science were searched for retrieving and summarizing studies published up to October 2020 investigating the association between chronic medical conditions and ANM. All types of observational studies published in the English language were eligible to be included in the systematic review. Studies needed to report the effect of at least one chronic disease on ANM. Studies with other designs, studies with unreliable and incomplete results, and those that assessed none of the chronic diseases as outcomes of interest were excluded. Of the 6294 records retrieved by searching the databases, a total of 28 observational studies were included for this review. According to the Newcastle-Ottawa scale, nine studies were classified as high-quality, fifteen studies as moderate, and four as low-quality. Among the five studies investigating the association between polycystic ovary syndrome (PCOS) and ANM, three studies reported that PCOS was associated with a later ANM, whereas others found no such association. Eight studies showed that diabetes was associated with an earlier ANM, whereas eight other studies found no such association. While only one study showed a younger age at the onset of menopause in patients with a history of hypertension, five studies did not report such an effect. Only one study assessed the effect of dyslipidemia on ANM and showed no association between these variables. While three studies documented the effects of cardiovascular diseases (CVD) and heart disease on earlier ANM, one study found no association between these diseases and ANM. Most included studies showed the association of mood disorders with earlier ANM. There were no sufficient data for assessing the effects of thyroid, skin, and autoimmune diseases on ANM. Chronic diseases particularly cardio-metabolic disturbances, cardiovascular events, and psycho-emotional disorders are associated with earlier menopause, whereas other diseases such as PCOS may lead to later menopause. Accordingly, early diagnosis and managing chronic medical conditions in women can potentially prevent early or late menopause.
尽管有几项关于自然绝经年龄 (ANM) 及其相关因素的现有研究，但关于慢性疾病与 ANM 之间关联的流行病学数据很少，且结果存在冲突和不确定性。本系统评价的目的是总结研究慢性疾病与 ANM 之间关系的结果。通过检索 PubMed、Scopus 和 Web of Science，检索并总结了截至 2020 年 10 月调查慢性医疗状况与 ANM 之间关系的研究。所有类型的观察性研究，只要以英文发表，均有资格纳入系统评价。研究需要报告至少一种慢性疾病对 ANM 的影响。其他设计的研究、结果不可靠和不完整的研究以及评估与兴趣无关的慢性疾病的研究均被排除在外。通过数据库检索共检索到 6294 条记录，其中共有 28 项观察性研究纳入本综述。根据纽卡斯尔-渥太华量表，9 项研究被归类为高质量，15 项研究为中等质量，4 项研究为低质量。在五项研究多囊卵巢综合征 (PCOS) 与 ANM 之间的关系中，三项研究报告 PCOS 与较晚的 ANM 相关，而其他研究则没有发现这种关联。八项研究表明糖尿病与 ANM 提前有关，而八项其他研究则没有发现这种关联。只有一项研究表明有高血压病史的患者绝经年龄较早，而五项研究则没有报告这种影响。只有一项研究评估了血脂异常对 ANM 的影响，表明这些变量之间没有关联。虽然三项研究记录了心血管疾病 (CVD) 和心脏病对更早的 ANM 的影响，但一项研究发现这些疾病与 ANM 之间没有关联。大多数纳入的研究表明情绪障碍与更早的 ANM 有关。没有足够的数据评估甲状腺、皮肤和自身免疫性疾病对 ANM 的影响。慢性疾病，特别是心血管代谢紊乱、心血管事件和心理情绪障碍，与绝经提前有关，而其他疾病如 PCOS 可能导致绝经较晚。因此，早期诊断和管理女性的慢性疾病可能潜在地预防绝经提前或延迟。
