Jansen Erica C, Stern Dalia, Peterson Karen E, Lajous Martin, López-Ridaura Ruy
Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
CONACyT-Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico.
Matern Child Health J. 2019 Mar;23(3):356-368. doi: 10.1007/s10995-018-2650-7.
Objectives To evaluate whether age at menarche and time to menstrual regularity were related to cardio-metabolic risk factors in Mexican women. Methods The study population comprised 54,921 women from the 2008-2010 wave of the Mexican Teacher's Cohort. A modified Poisson approach was used; exposures were age at menarche and time to menstrual regularity (< 1 year vs. ≥1 year), and outcomes were prevalent obesity, type 2 diabetes, high blood pressure, and high cholesterol. Results Mean (SD) age of women was 42.1 (7.6) years, and mean (SD) menarcheal age was 12.5 (1.5) years. Compared to women with menarche age 13 years, those with menarche < 9 years had a 65% (95% CI 43-90%); 27% (95% CI 4-55%); and 23% (95% CI 1-49%) higher prevalence of obesity, high blood pressure, and high cholesterol, respectively. For diabetes, there was a U-shaped association; compared to menarche age 13 years, those with menarche < 9 years had an 89% higher prevalence of diabetes (95% CI 39-156%), and those with menarche ≥ 17 years had a 65% higher prevalence (95% CI 16-134%). Among women with regular cycles (n = 43,113), a longer time to menstrual regularity was associated with diabetes (PR = 1.11 with 95% CI 1.02-1.22), high blood pressure (PR = 1.11 with 95% CI 1.06-1.17), and high cholesterol (PR = 1.09 with 95% CI 1.04-1.14). Conclusions for practice Mexican women with earlier and later ages at menarche and/or longer time to menstrual regularity may have higher risk of cardio-metabolic disease in adulthood.
目的 评估初潮年龄和月经规律所需时间是否与墨西哥女性的心血管代谢危险因素相关。方法 研究人群包括来自墨西哥教师队列2008 - 2010年波次的54921名女性。采用改良泊松方法;暴露因素为初潮年龄和月经规律所需时间(<1年与≥1年),结局为肥胖、2型糖尿病、高血压和高胆固醇的患病率。结果 女性的平均(标准差)年龄为42.1(7.6)岁,平均(标准差)初潮年龄为12.5(1.5)岁。与初潮年龄为13岁的女性相比,初潮年龄<9岁的女性肥胖、高血压和高胆固醇的患病率分别高65%(95%置信区间43 - 90%)、27%(95%置信区间4 - 55%)和23%(95%置信区间1 - 49%)。对于糖尿病,存在U型关联;与初潮年龄为13岁的女性相比,初潮年龄<9岁的女性糖尿病患病率高89%(95%置信区间39 - 156%),初潮年龄≥17岁的女性患病率高65%(95%置信区间16 - 134%)。在月经周期规律的女性(n = 43113)中,月经规律所需时间较长与糖尿病(风险比=1.11,95%置信区间1.02 - 1.22)、高血压(风险比=1.11,95%置信区间1.06 - 1.17)和高胆固醇(风险比=1.09,95%置信区间1.04 - 1.14)相关。实践结论 初潮年龄过早或过晚以及/或月经规律所需时间较长的墨西哥女性在成年后患心血管代谢疾病的风险可能更高。