Idade da Menarca e Risco Cardiometabólico em Adolescentes e Mulheres Adultas: Revisão Sistemática
Age at Menarche and Cardiometabolic Risk in Adolescent Girls and Adult Women: A Systematic Review
DOI:
https://doi.org/10.22258/hgh.v10i3.463Resumo
Introdução: A idade da menarca pode refletir padrões precoces de risco metabólico e tem sido associada à obesidade, diabetes, hipertensão e doença cardiovascular em fases posteriores da vida. Objetivo: Comparar o risco cardiometabólico entre adolescentes e mulheres adultas com menarca precoce, normal e tardia por meio de uma revisão sistemática. Métodos: Foi realizada uma busca sistemática nas bases MEDLINE/PubMed e Scopus, seguindo as diretrizes PRISMA 2020. Foram incluídos estudos observacionais, estudos de coorte, estudos transversais, estudos de caso-controle, análises populacionais e estudos genéticos publicados entre 2021 e 2026, que avaliaram a idade da menarca em relação à obesidade, síndrome metabólica, diabetes mellitus tipo 2, resistência à insulina, hipertensão, dislipidemia ou doença cardiovascular. A seleção foi realizada por dois revisores independentes utilizando o Rayyan; as discordâncias foram resolvidas por consenso ou por um terceiro revisor. A qualidade metodológica foi avaliada por meio das ferramentas do National Heart, Lung, and Blood Institute (NHLBI). Foram incluídos 36 estudos na síntese narrativa. O protocolo foi registrado no PROSPERO sob o código CRD420261301527. Resultados: A maioria dos estudos apresentou qualidade metodológica boa ou regular. A menarca precoce esteve associada a maior risco de obesidade geral e abdominal, síndrome metabólica, hipertensão, dislipidemia, resistência à insulina e diabetes mellitus tipo 2. A associação foi mais consistente para adiposidade e síndrome metabólica, enquanto os desfechos glicêmicos e cardiovasculares apresentaram maior heterogeneidade. Algumas associações foram atenuadas após o ajuste pelo índice de massa corporal, sugerindo um possível papel mediador da adiposidade. Vários estudos identificaram associações não lineares, com maior risco também entre mulheres com menarca tardia. Conclusões: A menarca precoce parece ser um marcador clínico precoce de suscetibilidade cardiometabólica. São necessários estudos de coorte prospectivos para esclarecer a causalidade, os fatores mediadores e os pontos de corte específicos para diferentes populações.Downloads
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