閉経期ホルモン療法と長期的な死亡率:全国的な,レジスタベースのコホート研究
Anders Pretzmann Mikkelsen1,2, Thomas Bergholt3,4, Øjvind Lidegaard4,5
1Department of Gynaecology and Obstetrics, Copenhagen University Hospital Herlev, 2730 Herlev, Denmark anders.mikkelsen@regionh.dk.
BMJ (Clinical research ed.)
|February 18, 2026
まとめ
閉経期ホルモン療法 (MHT) の使用は,デンマークの大規模なコホート研究において,全因死亡のリスクの増加と関連していなかった. 研究結果は,MHTは長期使用でも,全体的な死亡率に関して安全であることを示唆しています.
科学分野:
- 生殖医学は,生殖器医学である.
- 公衆衛生は公衆衛生である.
- エピデミオロジー エピデミオロジー
背景:
- 更年期ホルモン療法 (MHT) は,更年期症状の管理に広く使用されています.
- 長期的な死亡率に対するMHTの影響に関する懸念は依然として存在しています.
- MHTと全原因死亡率との関連を明確にするために,堅実な証拠が必要です.
研究 の 目的:
- 閉経期ホルモン療法の使用と全因死亡率との関連を調査する.
- MHT使用に関連した特定死因のリスクを評価する.
- 双方の卵巣摘出術を受けた女性の死亡率に対するMHTの影響を評価する.
主な方法:
- デンマークにおける全国的な,レジストリベースのコホート研究.
- 1950年から1977年まで生まれた女性を含み,45歳から2023年7月まで追跡調査を行った.
- コックス回帰を用いて,死亡率の調整された危険比率を推定し,多数の共変数を制御した.
主要な成果:
- MHTの使用は,全死亡リスク比率のわずかに低下 (0.96;95%CI 0.93-0.98) と関連していました.
- MHTの使用期間によって死亡リスクの増加は認められず,一部の期間ではリスクが低下した.
- 双方の卵巣切除術を受けた女性では,MHTの使用は27~34%低い死亡リスクと関連していました.
結論:
- この研究では,閉経期ホルモン療法が全因死亡のリスクを増やすという証拠は見つかりませんでした.
- 研究結果は,MHTは,長時間使用であっても,死亡率の増加と関連していないことを示唆しています.
- MHTは,卵巣切除術後の女性など,特定のサブグループにおける死亡率の低下と関連している可能性があります.
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