Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan.
Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University, Shenzhen.
J Hypertens. 2021 Mar 1;39(3):476-483. doi: 10.1097/HJH.0000000000002672.
The study aimed to explore the association of age at menarche with hypertension and whether adiposity and insulin resistance mediated the association in rural Chinese women.
We conducted a cross-sectional study enrolling 7518 women (median age 56 years) from a rural Chinese area from 2013 to 2014. Adiposity was measured by BMI and waist circumference, and insulin resistance was measured by the homeostasis model assessment of insulin resistance (HOMA-IR) index. Odds ratios (ORs) and 95% confidence limits (Cls) for the association of age at menarche with hypertension were estimated by using multivariate logistic regression models. The contribution of adiposity and insulin resistance to the association was estimated by mediation analysis.
Among 7518 women, 3187 (42.39%) had hypertension. Age at menarche was inversely associated with hypertension (per additional year of menarche, OR = 0.965, 95% Cl: 0.935-0.995). BMI or waist circumference and HOMA-IR completely mediated the association of age at menarche with hypertension (for BMI and HOMA-IR: total indirect effect: OR = 0.970, 95% Cl: 0.962-0.978 and direct effect: OR = 0.994, 95% Cl: 0.963-1.026; for waist circumference and HOMA-IR: total indirect effect: OR = 0.981, 95% Cl: 0.973-0.988 and direct effect: OR = 0.983, 95% Cl: 0.952-1.014).
Early age at menarche was positively associated with hypertension. Adiposity and insulin resistance seemed to be two vital mediators of the association between age at menarche and hypertension in rural Chinese women.
本研究旨在探讨初潮年龄与高血压的关系，以及肥胖和胰岛素抵抗是否介导了这种关系在中国农村女性中。
我们进行了一项横断面研究，纳入了 2013 年至 2014 年期间来自中国农村地区的 7518 名女性（中位年龄 56 岁）。肥胖程度通过 BMI 和腰围来衡量，胰岛素抵抗通过稳态模型评估的胰岛素抵抗指数（HOMA-IR）来衡量。使用多变量 logistic 回归模型估计初潮年龄与高血压的关联的比值比（OR）和 95%置信区间（Cl）。通过中介分析估计肥胖和胰岛素抵抗对这种关联的贡献。
在 7518 名女性中，有 3187 人（42.39%）患有高血压。初潮年龄与高血压呈负相关（每增加一年初潮，OR=0.965，95%Cl：0.935-0.995）。BMI 或腰围和 HOMA-IR 完全介导了初潮年龄与高血压的关联（对于 BMI 和 HOMA-IR：总间接效应，OR=0.970，95%Cl：0.962-0.978，直接效应，OR=0.994，95%Cl：0.963-1.026；对于腰围和 HOMA-IR：总间接效应，OR=0.981，95%Cl：0.973-0.988，直接效应，OR=0.983，95%Cl：0.952-1.014）。
初潮年龄较早与高血压呈正相关。肥胖和胰岛素抵抗似乎是初潮年龄与中国农村女性高血压之间关系的两个重要中介因素。
