The Association of Female Reproductive Factors with Glaucoma and Related Traits: A Systematic Review.
The Association of Female Reproductive Factors with Glaucoma and Related Traits: A Systematic Review.
复制标题
DOI：
10.1016/j.ogla.2022.06.003
复制
发表时间：
2022-11
影响因子：
2.9
通讯作者：
Khawaja, Anthony P.
中科院分区：
文献类型：
--
作者：
Madjedi, Kian M.;V. Stuart, Kelsey;Chua, Sharon Y. L.;Foster, Paul J.;Strouthidis, Nicholas G.;Luben, Robert N.;Warwick, Alasdair N.;Kang, Jae H.;Wiggs, Janey L.;Pasquale, Louis R.;Khawaja, Anthony P.
本系统综述总结了女性生殖因素（初潮年龄、产次、口服避孕药[OC]使用、绝经年龄和绝经后激素[PMH]使用）与眼内压（IOP）或开角型青光眼（OAG）之间相关性的证据。了解女性生殖因素与青光眼之间的关系，可能有助于阐明疾病的发病机制，并有助于临床预测和个性化治疗策略。重要的是，有些因素是可以改变的，这可能会导致新的治疗方法。由两名评价者独立提取MEDLINE、Embase、科克伦系统评价数据库和科克伦对照试验中心注册数据库中的文章，以识别相关研究。合格标准包括年龄> 18岁的人类受试者的研究; IOP或OAG的测量结果;队列、病例对照、横断面或随机对照试验设计;报告的相关性测量，如风险比、相对风险、比值比或平均差异，以及相关置信区间;以及测量的以下变量中至少一个的暴露：初潮年龄、产次、OC使用、绝经年龄或PMH使用。共纳入27项研究。研究设计、暴露和治疗水平、治疗持续时间和变量报告的实质性差异排除了对已识别研究进行有意义的定量综合。总体而言，PMH使用与较低IOP之间的相关性相对一致。仅使用雌激素的PMH可能与较低的OAG风险相关，这可能会因种族而改变。未发现与雌激素和孕酮联合使用PMH有显著相关性。未发现产次或初潮年龄与青光眼之间存在强相关性，但绝经年龄越小，青光眼风险越高，且与OC使用持续时间越长相关，但未发现与OC使用的总体相关性。PMH使用与较低IOP或OAG风险之间的相关性是一个潜在的临床相关和可改变的风险因素，应进一步研究。尽管这需要在纳入研究的高偏倚风险背景下进行解释。未来的研究应特别检查IOP的相关性，以及遗传因素和OAG风险之间的关系如何受到女性生殖因素的影响。
This systematic review summarizes evidence for associations between female reproductive factors (age at menarche, parity, oral contraceptive [OC] use, age at menopause, and postmenopausal hormone [PMH] use) and intraocular pressure (IOP) or open-angle glaucoma (OAG). Understanding the associations between female reproductive factors and glaucoma may shed light on the disease pathogenesis and aid clinical prediction and personalized treatment strategies. Importantly, some factors are modifiable, which may lead to new therapies. Two reviewers independently extracted articles in MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials databases to identify relevant studies. Eligibility criteria included studies with human subjects aged > 18 years; a measured outcome of either IOP or OAG; a cohort, case-control, cross-sectional, or randomized controlled trial design; a reported measure of association, such as the hazard ratio, relative risk, odds ratio, or mean difference, with an associated confidence interval; and a measured exposure of at least 1 of the following variables: age at menarche, parity, OC use, age at menopause, or PMH use. We included a total of 27 studies. Substantial differences in study designs, exposure and treatment levels, treatment durations, and variable reporting precluded a meaningful quantitative synthesis of the identified studies. Overall, relatively consistent associations between PMH use and a lower IOP were identified. Estrogen-only PMH use may be associated with lower OAG risk, which may be modified by race. No significant associations were found with combined estrogen-and-progesterone PMH use. No strong associations between parity or age at menarche and glaucoma were found, but a younger age at menopause was associated with an increased glaucoma risk, and adverse associations were identified with a longer duration of OC use, though no overall association with OC use was found. The association between PMH use and lower IOP or OAG risk is a potentially clinically relevant and modifiable risk factor and should be investigated further, although this needs to be interpreted in the context of a high risk of bias across included studies. Future research should examine associations with IOP specifically and how the relationship between genetic factors and OAG risks may be influenced by female reproductive factors.
登录
查看更多内容
影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
4.4
作者：
Deschenes, Micheline C.;Descovich, Denise;Lesk, Mark R.
通讯作者：
Lesk, Mark R.
影响因子：
4.1
作者：
Foster, PJ;Buhrmann, R;Johnson, GJ
通讯作者：
Johnson, GJ
影响因子：
1.8
作者：
Biro, Frank M.;Pajak, Ashley;Teitelbaum, Susan L.
通讯作者：
Teitelbaum, Susan L.
影响因子：
1.8
作者：
Hoopes, Andrea J.;Teal, Stephanie B.;Sheeder, Jeanelle
通讯作者：
Sheeder, Jeanelle