Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba.
Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.
J Atheroscler Thromb. 2023 Mar 1;30(3):247-254. doi: 10.5551/jat.63321. Epub 2022 May 18.
In this study, we aimed to evaluate the association between age at menarche and risk of cardiovascular disease mortality.
In total, 54,937 women aged 40-79 years old between 1988 and 1990 without a history of cardiovascular disease were eligible for analysis and were followed through December 2009. We used the Cox proportional hazards models to examine the association between age at menarche and risk of cardiovascular disease.
Compared with women with age at menarche of 15 years, the hazard ratios (95% confidence intervals) of stroke were 1.22 (0.85-1.75) for women with age at menarche of 9-12 years, 1.08 (0.85-1.36) for those of 13 years, 1.23 (1.02-1.47) for those of 14 years, 1.27 (1.07-1.50) for those of 16 years, 1.16 (0.95-1.41) for those of 17 years, and 1.39(1.16-1.68) for those of 18-20 years (P for trend=0.045). A similar pattern was observed for hemorrhagic stroke, ischemic stroke, and total cardiovascular disease. No such association was found for coronary heart disease. When stratified by age, for women aged 40-59 at baseline, the similar U-shaped association was observed. In contrast, for women aged 60-79 years at baseline, a significantly high hazard ratio was noted in the group of late age at menarche, but not in the group of early age at menarche.
Both women with early and late age at menarche were determined to have higher risk of death from stroke and cardiovascular disease.
本研究旨在评估初潮年龄与心血管疾病死亡风险之间的关系。
共有 54937 名年龄在 40-79 岁之间、无心血管疾病病史的女性符合分析条件,随访至 2009 年 12 月。我们使用 Cox 比例风险模型来检验初潮年龄与心血管疾病风险之间的关系。
与初潮年龄为 15 岁的女性相比,初潮年龄为 9-12 岁的女性中风风险比(95%置信区间)为 1.22(0.85-1.75),13 岁为 1.08(0.85-1.36),14 岁为 1.23(1.02-1.47),16 岁为 1.27(1.07-1.50),17 岁为 1.16(0.95-1.41),18-20 岁为 1.39(1.16-1.68)(趋势 P=0.045)。同样的模式也适用于出血性中风、缺血性中风和总心血管疾病。对于冠心病,没有发现这种相关性。按年龄分层,对于基线年龄为 40-59 岁的女性,观察到类似的 U 形关联。相反,对于基线年龄为 60-79 岁的女性,在初潮年龄较晚的组中,风险比显著升高,但在初潮年龄较早的组中,没有显著升高。
初潮年龄较早和较晚的女性发生中风和心血管疾病死亡的风险均较高。