月經周期不規律和較長增加過早死亡風險
作者：
小柯機器人發布時間：2020/10/7 23:31:38
美國哈佛大學陳曾熙公共衛生學院Jorge E Chavarro團隊研究了月經周期的規律性與過早死亡風險之間的關係。2020年9月30日，該研究發表在《英國醫學雜誌》上。
為了評估整個生命過程中月經周期不規律或較長是否與全因或特定原因的過早死亡（年齡<70歲）有關，研究組進行了一項前瞻性隊列研究。共招募了79505名無心血管疾病、癌症或糖尿病病史的絕經前女性，她們報告了14-17歲、18-22歲和29-46歲的正常月經周期和長度。
在24年的隨訪中，共有1975例過早死亡，包括894例癌症和172例心血管疾病。總是月經周期不規律的女性，與相同年齡範圍內周期規律的女性相比，隨訪期間的死亡率更高。
14-17歲時月經周期非常規律的女性和月經周期總是不規律的女性每1000人年隨訪的粗死亡率分別為1.05例和1.23例，18-22歲年齡段分別為1.00例和1.37例，29-46歲年齡段則分別為1.00例和1.68例。各年齡段過早死亡的相應多變量校正風險比分別為1.18、1.37和1.39。
18-22歲和29-46歲年齡段月經周期為40天及以上的女性，與相同年齡範圍內周期為26-31天的正常女性相比，更容易過早死亡，風險比分別為1.34和1.40。在與心血管疾病有關的死亡中，這些相關性最為明顯。在目前的吸菸者中，月經周期較長和不規律的女性死亡率更高。
總之，青春期和成年期月經周期不規律和較長與過早死亡（年齡<70歲）的高風險有關。
附：英文原文
Title: Menstrual cycle regularity and length across the reproductive lifespan and risk of premature mortality: prospective cohort study
Author: Yi-Xin Wang, Mariel Arvizu, Janet W Rich-Edwards, Jennifer J Stuart, JoAnn E Manson, Stacey A Missmer, An Pan, Jorge E Chavarro
Issue&Volume: 2020/09/30
Abstract:
Objective To evaluate whether irregular or long menstrual cycles throughout the life course are associated with all cause and cause specific premature mortality (age <70 years).
Design Prospective cohort study.
Setting Nurses』 Health Study II (1993-2017).
Participants 79505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages 14-17 years, 18-22 years, and 29-46 years.
Main outcome measures Hazard ratios and 95% confidence intervals for all cause and cause specific premature mortality (death before age 70 years) were estimated from multivariable Cox proportional hazards models.
Results During 24 years of follow-up, 1975 premature deaths were documented, including 894 from cancer and 172 from cardiovascular disease. Women who reported always having irregular menstrual cycles experienced higher mortality rates during follow-up than women who reported very regular cycles in the same age ranges. The crude mortality rate per 1000 person years of follow-up for women reporting very regular cycles and women reporting always irregular cycles were 1.05 and 1.23 for cycle characteristics at ages 14-17 years, 1.00 and 1.37 for cycle characteristics at ages 18-22 years, and 1.00 and 1.68 for cycle characteristics at ages 29-46 years. The corresponding multivariable adjusted hazard ratios for premature death during follow-up were 1.18 (95% confidence interval 1.02 to 1.37), 1.37 (1.09 to 1.73), and 1.39 (1.14 to 1.70), respectively. Similarly, women who reported that their usual cycle length was 40 days or more at ages 18-22 years and 29-46 years were more likely to die prematurely than women who reported a usual cycle length of 26-31 days in the same age ranges (1.34, 1.06 to 1.69; and 1.40, 1.17 to 1.68, respectively). These relations were strongest for deaths related to cardiovascular disease. The higher mortality associated with long and irregular menstrual cycles was slightly stronger among current smokers.
Conclusions Irregular and long menstrual cycles in adolescence and adulthood are associated with a greater risk of premature mortality (age <70 years). This relation is slightly stronger among women who smoke.
DOI: 10.1136/bmj.m3464
Source: https://www.bmj.com/content/371/bmj.m3464