Department of Paediatrics, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Box 116, Cambridge, CB2 0QQ, UK.
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK.
Acta Diabetol. 2018 Aug;55(8):853-859. doi: 10.1007/s00592-018-1162-7. Epub 2018 May 22.
Associations have been reported between age at menarche and the later risk of gestational diabetes. However, it is not known whether these associations reflect differences in insulin sensitivity and/or pancreatic β-cell function in pregnancy.
We examined this question in women enrolled in the prospective Cambridge Baby Growth Study who recalled their age at menarche in questionnaires during pregnancy. Polynomial logistic and linear regression models were used to relate menarche timing to the risk of gestational diabetes, both unadjusted and adjusted for the Homeostasis Model Assessments of insulin resistance (HOMA IR) and pancreatic β-cell function (HOMA B) at week 28 of pregnancy.
Age at menarche showed a U-shaped association with gestational diabetes risk (linear term: p = 9.5 × 10; quadratic term: p = 1.0 × 10; n = 889; overall model p = 8.1 × 10). Age at menarche showed a negative linear association with insulin resistance (HOMA IR: β = -0.13, p = 5.2 × 10, n = 771), which explained the relationship between age at menarche and gestational diabetes risk (adjusted linear term going from p = 0.03-0.08; adjusted quadratic term going from p = 0.04-0.08; n = 771). Age at menarche also showed a negative linear association with β-cell function (HOMA B: β = -0.11, p = 2.8 × 10, n = 771) but this did not attenuate the relationship between age at menarche and gestational diabetes (adjusted linear term p = 0.02; adjusted quadratic term p = 0.03, n = 771).
These results suggest that the associations between age at menarche and risk of gestational diabetes and raised pregnancy glucose concentrations may be mediated by insulin resistance.
已有研究报告，初潮年龄与妊娠期糖尿病的后期发病风险相关。然而，目前尚不清楚这些关联是否反映了妊娠期间胰岛素敏感性和/或胰岛β细胞功能的差异。
我们在参加前瞻性剑桥婴儿生长研究的女性中研究了这个问题，这些女性在怀孕期间的问卷调查中回忆了她们的初潮年龄。使用多项式逻辑和线性回归模型，在未调整和调整了妊娠 28 周时的胰岛素抵抗（HOMA IR）和胰岛β细胞功能（HOMA B）的情况下，将初潮时间与妊娠期糖尿病的风险相关联。
初潮年龄与妊娠期糖尿病风险呈 U 型关联（线性项：p=9.5×10；二次项：p=1.0×10；n=889；总模型 p=8.1×10）。初潮年龄与胰岛素抵抗呈负线性关联（HOMA IR：β=-0.13，p=5.2×10，n=771），这解释了初潮年龄与妊娠期糖尿病风险之间的关系（调整后的线性项从 p=0.03-0.08；调整后的二次项从 p=0.04-0.08；n=771）。初潮年龄也与胰岛β细胞功能呈负线性关联（HOMA B：β=-0.11，p=2.8×10，n=771），但这并没有减弱初潮年龄与妊娠期糖尿病之间的关系（调整后的线性项 p=0.02；调整后的二次项 p=0.03，n=771）。
这些结果表明，初潮年龄与妊娠期糖尿病和妊娠血糖升高风险之间的关联可能是通过胰岛素抵抗介导的。
