Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Department of Preventive Medicine, Shenzhen University Health Science Center, Shenzhen, Guangdong, People's Republic of China.
Menopause. 2020 May;27(5):579-585. doi: 10.1097/GME.0000000000001504.
This study aimed to explore the association between age at menarche and type 2 diabetes mellitus (T2DM) and whether the association is mediated by adiposity and insulin resistance (IR) in rural Chinese women.
This cross-sectional study analyzed data for 7,460 women (median age 56 y) from a rural Chinese area from 2013 to 2014. Data were collected by standardized interviews and anthropometric and laboratory measurements. Adiposity was measured by body mass index (BMI), and IR was measured by the homeostasis model assessment of IR (HOMA-IR) index. Multivariate logistic regression models were used to estimate odds ratios (ORs) and 95% confidence limits (CLs) for the association between age at menarche and T2DM. Mediation analysis was performed to explore the contribution of BMI and HOMA-IR to the association between age at menarche and T2DM.
Among 7,460 women, 840 (11.26%) had T2DM. After adjusting for potential confounding factors, the odds of T2DM with the latest age at menarche 18 years or older versus 13 years was reduced (OR = 0.65, 95% CL: 0.47, 0.91), and age at menarche was negatively associated with T2DM (per additional year of menarche, OR = 0.95, 95% CL: 0.91, 0.99). BMI and HOMA-IR completely mediated the association between age at menarche and T2DM (total indirect effect: OR = 0.973, 95% CL: 0.961, 0.986; direct effect: OR = 0.974, 95% CL: 0.930, 1.021).
Late menarche may be negatively associated with T2DM. The potential mechanism is adiposity and IR completely mediating the association between age at menarche and T2DM.
本研究旨在探讨中国农村女性初潮年龄与 2 型糖尿病（T2DM）之间的关联，以及这种关联是否通过肥胖和胰岛素抵抗（IR）介导。
本横断面研究分析了 2013 年至 2014 年中国农村地区 7460 名女性（中位年龄 56 岁）的数据。数据通过标准化访谈和人体测量学及实验室测量收集。肥胖程度用体重指数（BMI）衡量，IR 用稳态模型评估的 IR（HOMA-IR）指数衡量。采用多变量 logistic 回归模型估计初潮年龄与 T2DM 之间的关联的比值比（OR）和 95%置信区间（CL）。采用中介分析探讨 BMI 和 HOMA-IR 对初潮年龄与 T2DM 之间关联的贡献。
在 7460 名女性中，840 人（11.26%）患有 T2DM。在调整了潜在混杂因素后，最晚初潮年龄为 18 岁或以上的 T2DM 患病几率降低（OR=0.65，95%CL：0.47，0.91），初潮年龄与 T2DM 呈负相关（每增加一年初潮，OR=0.95，95%CL：0.91，0.99）。BMI 和 HOMA-IR 完全介导了初潮年龄与 T2DM 之间的关联（总间接效应：OR=0.973，95%CL：0.961，0.986；直接效应：OR=0.974，95%CL：0.930，1.021）。
晚初潮可能与 T2DM 呈负相关。潜在机制是肥胖和 IR 通过完全介导初潮年龄与 T2DM 之间的关联。
