Department of Public Health and Melvin and Bren Simon Cancer Center, School of Medicine, Indiana University, 980 West Walnut Street, R3-C241, Indianapolis, IN 46202, USA.
Am J Epidemiol. 2010 Feb 1;171(3):334-44. doi: 10.1093/aje/kwp372. Epub 2009 Dec 21.
The authors investigated the association between age at menarche and risk of type 2 diabetes mellitus (T2DM) among 101,415 women from the Nurses' Health Study (NHS) aged 34-59 years (1980-2006) and 100,547 women from Nurses' Health Study II (NHS II) aged 26-46 years (1991-2005). During 2,430,274 and 1,373,875 person-years of follow-up, respectively, 7,963 and 2,739 incident cases of T2DM were documented. Young age at menarche was associated with increased risk of T2DM after adjustment for potential confounders, including body figure at age 10 years and body mass index (BMI; weight (kg)/height (m)(2)) at age 18 years. Relative risks of T2DM across age-at-menarche categories (< or =11, 12, 13, 14, and > or =15 years) were 1.18 (95% confidence interval (CI): 1.10, 1.27), 1.09 (95% CI: 1.02, 1.17), 1.00 (referent), 0.92 (95% CI: 0.83, 1.01), and 0.95 (95% CI: 0.84, 1.06), respectively, in the NHS (P for trend < 0.0001) and 1.40 (95% CI: 1.24, 1.57), 1.13 (95% CI: 1.00, 1.27), 1.00 (referent), 0.98 (95% CI: 0.82, 1.18), and 0.96 (95% CI: 0.78, 1.19), respectively, in NHS II (P for trend < 0.0001). Associations were substantially attenuated after additional control for updated time-varying BMI. These data suggest that early menarche is associated with increased risk of T2DM in adulthood. The association may be largely mediated through excessive adult adiposity. The association was stronger among younger women, supporting a role for sex hormones in younger onset of T2DM, in addition to BMI.
作者在研究中调查了 101415 名年龄在 34-59 岁（1980-2006 年）的护士健康研究（NHS）女性和 100547 名年龄在 26-46 岁（1991-2005 年）的护士健康研究 II（NHS II）女性的初潮年龄与 2 型糖尿病（T2DM）风险之间的关系。分别随访了 2430274 人和 1373875 人年，记录了 7963 例和 2739 例 T2DM 新发病例。初潮年龄较早与 T2DM 风险增加相关，调整了潜在混杂因素后仍然如此，这些因素包括 10 岁时的体型和 18 岁时的体重指数（BMI；体重（kg）/身高（m）（2））。在 NHS（P<0.0001）中，按初潮年龄分类（≤11、12、13、14 和≥15 岁）的 T2DM 相对风险分别为 1.18（95%置信区间（CI）：1.10，1.27）、1.09（95% CI：1.02，1.17）、1.00（参照）、0.92（95% CI：0.83，1.01）和 0.95（95% CI：0.84，1.06），在 NHS II 中，相应的相对风险分别为 1.40（95% CI：1.24，1.57）、1.13（95% CI：1.00，1.27）、1.00（参照）、0.98（95% CI：0.82，1.18）和 0.96（95% CI：0.78，1.19），趋势检验 P<0.0001。在进一步控制更新的时间变化 BMI 后，相关性明显减弱。这些数据表明，初潮早与成年后患 2 型糖尿病的风险增加有关。这种关联可能主要通过成年后过度肥胖来介导。在较年轻的女性中，这种关联更强，这支持了性激素在年轻发病的 2 型糖尿病中的作用，而不仅仅是 BMI。
