Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway.
Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway.
Int J Epidemiol. 2023 Dec 25;52(6):1951-1958. doi: 10.1093/ije/dyad129.
Previous research suggests that alcohol consumption is associated with high age at menopause. Yet, knowledge about the dose-response relationship is inconsistent. Thus, we studied the pattern of the association of pre-menopausal alcohol consumption with age at natural menopause.
We performed a retrospective population-based study using self-reported data from 280 497 women aged 50-69 years attending the Norwegian breast cancer screening programme (BreastScreen Norway) during 2006-15. Associations of weekly alcohol consumption between the age of 20 and 49 years with age at menopause were estimated as hazard ratios (HRs) using Cox proportional hazard models with restricted cubic splines to allow for non-linear associations. We adjusted for year and place of birth, number of childbirths, educational level, body mass index and smoking habits.
Mean age at natural menopause was 51.20 years (interquartile range: 49-54 years). The adjusted HR of reaching menopause was highest for women with no alcohol consumption (reference) and the HR decreased by alcohol consumption up to 50 grams per week (adjusted HR 0.87; 95% CI: 0.86-0.88). Above 50 grams, there was no further decrease in the HR of reaching menopause (P for non-linearity of <0.001).
Women who did not consume alcohol were youngest at menopause. The lack of a dose-response association among alcohol consumers implies virtually no relation of alcohol consumption with age at menopause. Our findings may suggest that characteristics of the women who did not consume alcohol, not accounted for in the data analyses, explain their younger age at menopause.
先前的研究表明，饮酒与绝经年龄较大有关。然而，关于剂量-反应关系的知识并不一致。因此，我们研究了绝经前饮酒与自然绝经年龄之间的关联模式。
我们使用参加 2006-15 年挪威乳腺癌筛查计划（BreastScreen Norway）的 280497 名 50-69 岁女性的自我报告数据进行了一项回顾性基于人群的研究。使用 Cox 比例风险模型和限制立方样条来估计 20-49 岁时每周饮酒量与绝经年龄之间的关联，以允许非线性关联。我们调整了出生年份和地点、分娩次数、教育水平、体重指数和吸烟习惯。
自然绝经的平均年龄为 51.20 岁（四分位距：49-54 岁）。调整后的无饮酒女性达到绝经的风险比（HR）最高（参考），随着饮酒量的增加，HR 逐渐降低至每周 50 克（调整后的 HR 0.87；95%CI：0.86-0.88）。超过 50 克后，达到绝经的 HR 没有进一步下降（P<0.001，非线性检验）。
不饮酒的女性绝经年龄最小。饮酒者中没有剂量-反应关系表明，饮酒与绝经年龄几乎没有关系。我们的研究结果可能表明，没有饮酒的女性的特征，这些特征在数据分析中没有考虑到，解释了她们绝经年龄较早。
