Frontini M G, Srinivasan S R, Berenson G S
Tulane Center for Cardiovascular Health, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
Int J Obes Relat Metab Disord. 2003 Nov;27(11):1398-404. doi: 10.1038/sj.ijo.0802422.
To examine the longitudinal changes in adiposity and related risk variables of Syndrome X from childhood to young adulthood with respect to early onset of menarche.
Community-based longitudinal cohort of female subject (65% white, 35% blacks subjects) who participated in two or more surveys from childhood to young adulthood and had reported their menarcheal age (<12 y, n=437 vs > or =12 y, n=1042).
In childhood (5-11 y), adolescence (12-18 y), and young adulthood (19-37 y), females with early menarche displayed significantly higher body mass index (BMI) and triceps skinfold thickness; higher stature in childhood and adolescence; higher fasting insulin and homeostasis model assessment index of insulin resistance (HOMA-IR) in childhood and adulthood; and higher fasting glucose in adulthood. Blood pressure and lipoprotein variables showed no early menarche-related differences. Longitudinal rates of change in BMI (P=0.002), triceps skinfold thickness (P=0.05), insulin (P=0.09), and HOMA-IR (P=0.05) were positive and faster among female subjects with early menarche; fasting glucose decreased slowly in this group (P=0.006). In a multivariate analysis, body fatness and insulin related independently to early menarche (P<0.001). This association was stronger in white subjects (P=0.0008). In adulthood, the prevalence of clustering of three to four risk factors of syndrome X (highest quartile of: (1) BMI, (2) fasting insulin, (3) systolic or mean arterial pressure, and (4) total cholesterol to HDL cholesterol or triglycerides to HDL cholesterol ratio specific for age, race, and study year) was higher among those with early menarche (10.7 vs 6.2%, P=0.002). The odds for developing such clustering in adulthood among those with early menarche was 1.54 (95% CI=1.14-2.07), regardless of race.
Early menarche is characterized by excess body fatness and insulin beginning in early childhood and higher prevalence of clustering of adverse levels of risk variables of metabolic Syndrome X in young adulthood.
探讨初潮早发对从儿童期到青年期肥胖及代谢综合征相关风险变量的纵向影响。
以社区为基础的女性纵向队列研究（65%为白人，35%为黑人），这些女性从儿童期到青年期参与了两项或更多调查，并报告了她们的初潮年龄（<12岁，n = 437；≥12岁，n = 1042）。
在儿童期（5 - 11岁）、青春期（12 - 18岁）和青年期（19 - 37岁），初潮早发的女性体重指数（BMI）和肱三头肌皮褶厚度显著更高；在儿童期和青春期身高更高；在儿童期和成年期空腹胰岛素和胰岛素抵抗稳态模型评估指数（HOMA - IR）更高；在成年期空腹血糖更高。血压和脂蛋白变量未显示出与初潮早发相关的差异。初潮早发的女性受试者中，BMI（P = 0.002）、肱三头肌皮褶厚度（P = 0.05）、胰岛素（P = 0.09）和HOMA - IR（P = 0.05）的纵向变化率为正值且更快；该组空腹血糖下降缓慢（P = 0.006）。在多变量分析中，体脂和胰岛素与初潮早发独立相关（P < 0.001）。这种关联在白人受试者中更强（P = 0.0008）。在成年期，初潮早发者中代谢综合征X三到四个风险因素聚集（最高四分位数：(1) BMI，(2) 空腹胰岛素，(3) 收缩压或平均动脉压，以及(4) 特定年龄、种族和研究年份的总胆固醇与高密度脂蛋白胆固醇或甘油三酯与高密度脂蛋白胆固醇比值）更为常见（10.7%对6.2%，P = 0.002）。无论种族如何，初潮早发者成年期出现这种聚集的几率为1.54（95%可信区间 = 1.14 - 2.07）。
初潮早发的特征是从幼儿期开始出现体脂过多和胰岛素水平升高，以及在青年期代谢综合征X不良风险变量聚集的患病率更高。
