Department of Obstetrics and Gynecology, Beijing Tiantan Hospital, Capital Medical University, 119 South Fourth Ring Road West, Fengtai District, Beijing 100070, China.
Eur J Prev Cardiol. 2024 Sep 20;31(13):1595-1605. doi: 10.1093/eurjpc/zwae156.
Despite ischaemic stroke having much importance as one of the top 10 causes of death in older women, there are limited data on age at menopause and ischaemic stroke. We performed a systematic review and meta-analysis to estimate the effect of age at menopause on ischaemic stroke.
We screened four databases (PubMed, Cochrane, Web of Science, and EMBASE databases) up to 17 July 2023. This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and was registered with PROSPERO (CRD42023444245). Data extraction and quality assessment were independently undertaken by two reviewers. A random-effects model was used for meta-analysis using Revman5.4 to calculate the risk ratio of the incidence of ischaemic stroke. Heterogeneity was assessed using I2. Meta-regression and assessment for bias were performed. Out of 725 records identified, 10 studies were included in the qualitative synthesis and the quantitative meta-analysis. The pooled incidence rate for ischaemic strokes which age at menopause before 43 years old was 1.22 [95% confidence interval (CI): 1.02-1.46]. The pooled incidence rate of early menopause was 1.26 (95% CI: 1.07-1.48) for ischaemic stroke. The incidence rate of ischaemic stroke for women with early menopause may be in an environment with a high incidence for a long time.
This meta-analysis suggests that early menopause is associated with an increased risk of ischaemic stroke. Age at onset of menopause before 43 years old may be the cut-off value of increased risk of ischaemic stroke.
尽管缺血性中风是导致老年女性死亡的十大原因之一，但关于绝经年龄与缺血性中风的关系的数据有限。我们进行了一项系统评价和荟萃分析，以评估绝经年龄对缺血性中风的影响。
我们对四个数据库（PubMed、Cochrane、Web of Science 和 EMBASE 数据库）进行了筛选，检索时间截至 2023 年 7 月 17 日。本系统评价按照系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）指南进行报告，并在 PROSPERO（CRD42023444245）进行了注册。数据提取和质量评估由两名评审员独立进行。使用 Revman5.4 中的随机效应模型进行荟萃分析，以计算缺血性中风发病率的风险比。使用 I2 评估异质性。进行了荟萃回归和偏倚评估。在确定的 725 条记录中，有 10 项研究纳入了定性综合和定量荟萃分析。绝经前 43 岁的缺血性中风发生率为 1.22（95%置信区间[CI]：1.02-1.46）。绝经年龄较早的缺血性中风发生率为 1.26（95%CI：1.07-1.48）。早期绝经的女性发生缺血性中风的风险率可能处于长期高发的环境中。
这项荟萃分析表明，早期绝经与缺血性中风风险增加有关。绝经年龄早于 43 岁可能是缺血性中风风险增加的临界值。
