Department of Endocrinology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
Pancreatic Research Institute, Southeast University, Nanjing, China.
Gynecol Endocrinol. 2020 Apr;36(4):341-345. doi: 10.1080/09513590.2019.1658731. Epub 2019 Sep 3.
With the wide implementation of the universal two-child policy in China, the number of pregnant women in advanced maternal age (AMA) will increase gradually. We aimed to assess the association between age at menarche (AAM) and insulin resistance (IR) before delivery in AMA. A total of 80 pregnant women in AMA were consecutively enrolled before delivery in Zhongda hospital. Pregnant women were stratified into early menarche group and late menarche group according to the age of regular menstruation (about 13 years). At delivery, serum glucose and lipid levels were measured. IR was calculated by the method of homeostasis model assessment 2(HOMA2). The fasting blood insulin (17.68(9.72-36.71) and 10.35(7.76-15.10), respectively; = .006) and HOMA-IR (2.08(1.18-4.37) and 1.24(0.89-1.78), respectively; = .005) were higher in early menarche group than in late menarche group. AAM was inversely associated with HOMA-IR in AMA (= -0.27, = .014). In the multivariable analysis, AAM in late menarche group was negatively related to the level of HOMA-IR compared to those in early menarche group (= -2.275, ≤.0001). Taken together, our findings suggest that AAM was inversely associated with HOMA-IR in AMA. Furthermore, pregnant women in AMA with early menarche might have higher HOMA-IR levels than those with late menarche. Chinese Clinical Trial Registry (No. ChiCTR-RRC-16008714), retrospectively registered.
随着中国普遍二孩政策的实施，高龄产妇（AMA）的数量将逐渐增加。本研究旨在评估 AMA 孕妇初潮年龄（AAM）与分娩前胰岛素抵抗（IR）的关系。
本研究共连续纳入了中大医院 80 名 AMA 孕妇。根据初潮年龄（约 13 岁）将孕妇分为早潮组和晚潮组。分娩时检测血清血糖和血脂水平。采用稳态模型评估 2（HOMA2）法计算 IR。早潮组空腹胰岛素（17.68（9.72-36.71）和 10.35（7.76-15.10）， = .006）和 HOMA-IR（2.08（1.18-4.37）和 1.24（0.89-1.78）， = .005）均高于晚潮组。AAM 与 AMA 中的 HOMA-IR 呈负相关（ = -0.27， = .014）。在多变量分析中，与早潮组相比，晚潮组的 AAM 与 HOMA-IR 水平呈负相关（ = -2.275， ≤.0001）。
综上所述，本研究结果表明，AMA 中 AAM 与 HOMA-IR 呈负相关。此外，早潮的 AMA 孕妇可能比晚潮的 AMA 孕妇具有更高的 HOMA-IR 水平。
中国临床试验注册中心（注册号：ChiCTR-RRC-16008714），前瞻性注册。
