Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
Department of Chronic Disease Prevention and Control, Huai'an City Center for Disease Control and Prevention, Huai'an 223001, China.
J Diabetes Complications. 2018 Jul;32(7):623-629. doi: 10.1016/j.jdiacomp.2018.04.012. Epub 2018 May 16.
To investigate the influence of age at menarche (AM) and age at natural menopause (ANM) on glycemic control in patients with type 2 diabetes mellitus (T2DM).
A cross-sectional study was undertaken in Jiangsu, China. Logistic regression was used to evaluate the association between AM/ANM and glycemic control.
1195 (14.3%) premenopausal and 7149 (85.7%) postmenopausal women were included in this study. With the increase of AM per 1 year, patients had a low risk of uncontrolled FPG (≥7 mmol/L) and uncontrolled HbA1c (≥7%), as well as poor glycemic control (FPG ≥7 mmol/L and HbA1c ≥7%) after adjusting for age and BMI (model I, P < 0.05) with odds ratio (OR) 0.965, 0.978 and 0.962 respectively. Whereas after adjusting for age, BMI, education, duration of diabetes, smoking, drinking and antidiabetic treatment (model II) as well as further plus diabetic familial history and physical activity (model III), the association between AM and glycemic control was not significant (P > 0.05). Compared with premenopausal women, postmenopausal women had a low risk of uncontrolled FPG and uncontrolled HbA1c after adjusting for confounders in model II (P < 0.05). Furthermore, both patients with early ANM (<45 years) and late ANM (>55 years) had a high risk of uncontrolled HbA1c as well as poor glycemic control even adjusted for full confounders in model III (P < 0.05 for all).
Early AM, early and late ANM were significantly associated with worse glycemic control. Ascertaining the AM and ANM in women with T2DM may help to identify the risk predisposed to worse glycemic control.
探讨初潮年龄（AM）和自然绝经年龄（ANM）对 2 型糖尿病（T2DM）患者血糖控制的影响。
在中国江苏进行了一项横断面研究。采用 logistic 回归评估 AM/ANM 与血糖控制之间的关系。
本研究共纳入 1195 例（14.3%）绝经前和 7149 例（85.7%）绝经后妇女。调整年龄和 BMI 后，随着 AM 每增加 1 年，患者发生未控制 FPG（≥7mmol/L）和未控制 HbA1c（≥7%）以及血糖控制不良（FPG≥7mmol/L 和 HbA1c≥7%）的风险降低（模型 I，P<0.05），比值比（OR）分别为 0.965、0.978 和 0.962。然而，在校正年龄、BMI、教育程度、糖尿病病程、吸烟、饮酒和降糖治疗（模型 II）以及进一步加上糖尿病家族史和体力活动（模型 III）后，AM 与血糖控制之间的关联不再显著（P>0.05）。与绝经前妇女相比，调整模型 II 中的混杂因素后，绝经后妇女发生未控制 FPG 和未控制 HbA1c 的风险较低（P<0.05）。此外，调整模型 III 中的所有混杂因素后，早期 ANM（<45 岁）和晚期 ANM（>55 岁）的患者发生未控制 HbA1c 和血糖控制不良的风险均较高（均 P<0.05）。
早期 AM、早期和晚期 ANM 与血糖控制较差显著相关。在 T2DM 女性中确定 AM 和 ANM 可能有助于识别血糖控制不良的风险倾向。
