Edad de la menarquia y riesgo cardiometabólico en adolescentes y mujeres adultas: Revisión sistemática
Age at Menarche and Cardiometabolic Risk in Adolescent Girls and Adult Women: A Systematic Review
DOI:
https://doi.org/10.22258/hgh.v10i3.463Resumen
Introducción: La edad de la menarquia podría reflejar patrones tempranos de riesgo metabólico y se ha relacionado con obesidad, diabetes, hipertensión y enfermedad cardiovascular en etapas posteriores. Objetivo: Comparar el riesgo cardiometabólico en adolescentes y mujeres adultas con menarquia temprana, normal y tardía mediante una revisión sistemática. Metodología: Se realizó una búsqueda sistemática en MEDLINE/PubMed y Scopus, siguiendo PRISMA 2020. Se incluyeron estudios observacionales, cohortes, transversales, casos y controles, análisis poblacionales y estudios genéticos publicados entre 2021 y 2026, que evaluaron la edad de la menarquia en relación con obesidad, síndrome metabólico, diabetes mellitus tipo 2, resistencia a la insulina, hipertensión, dislipidemia o enfermedad cardiovascular. La selección se efectuó por dos revisores independientes mediante Rayyan; las discrepancias fueron resueltas por consenso o por un tercer revisor. La calidad metodológica se valoró con las herramientas del NHLBI. Se incluyeron 36 estudios para síntesis narrativa. El protocolo fue registrado en PROSPERO con el código CRD420261301527. Resultados: La mayoría de los estudios presentó calidad metodológica buena o regular. La menarquia temprana se asoció con mayor riesgo de obesidad general y abdominal, síndrome metabólico, hipertensión, dislipidemia, resistencia a la insulina y diabetes mellitus tipo 2. La asociación fue más consistente para adiposidad y síndrome metabólico; los desenlaces glucémicos y cardiovasculares mostraron mayor heterogeneidad. Algunas asociaciones se atenuaron tras ajustar por índice de masa corporal, sugiriendo un papel mediador de la adiposidad. Varios estudios identificaron patrones no lineales, con mayor riesgo también en menarquia tardía. Conclusiones: La menarquia temprana parece ser un marcador clínico temprano de susceptibilidad cardiometabólica. Se requieren cohortes prospectivas para aclarar causalidad, mediadores y puntos de corte poblacionales. Palabras clave: Menarquia; Síndrome Metabólico; Enfermedades Cardiovasculares; Enfermedades Metabólicas (Fuente: DeCS, BIREME).Descargas
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