Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Diabetes. 2021 Jun;13(6):458-468. doi: 10.1111/1753-0407.13128. Epub 2020 Dec 29.
Age at menarche was reported to be associated with the risk of diabetes. However, the impact of ideal cardiovascular health metrics (ICVHMs) on the association between age at menarche and adulthood diabetes risk was unclear.
We included 121 431 women from the nationwide, population-based cohort of the REACTION study (Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study). The diagnosis of diabetes was based on the oral glucose tolerance test (OGTT) and glycosylated hemoglobin (HbA1c) measurement. Logistic regression and multiplicative interaction analysis were conducted to investigate the potential interaction effect between age at menarche and ICVHMs on the development of diabetes.
The multivariable-adjusted odds ratios of diabetes across categories of age at menarche (<14, 14-17, and > 17 years) were 1.22 (95% confidence interval [CI]: 1.17, 1.28), 1.00 (reference), and 0.89 (95% CI: 0.85, 0.93), respectively. In subgroup analysis, significant interactions were detected between total cholesterol/blood pressure levels and age at menarche regarding the risk of diabetes (P for interaction = .0091 and .0019, respectively). The increased risk associated with age at menarche <14 years was observed in participants with three or fewer ICVHMs, but not in women with four or more ICVHMs (P for interaction = .0001).
Age at menarche was inversely associated with the risk of diabetes in adulthood in Chinese women, and it appeared to be modified by the presence of ICVHMs. Further studies are needed to clarify the precise interrelationship and the generalizability of our results.
初潮年龄与糖尿病风险相关。然而，理想心血管健康指标（ICVHMs）对初潮年龄与成年后糖尿病风险之间关联的影响尚不清楚。
我们纳入了来自全国范围内基于人群的 REACTION 研究（中国糖尿病患者癌症风险评估：一项纵向研究）的 121431 名女性。糖尿病的诊断基于口服葡萄糖耐量试验（OGTT）和糖化血红蛋白（HbA1c）测量。采用 logistic 回归和乘法交互作用分析来研究初潮年龄和 ICVHMs 之间潜在的交互作用对糖尿病发展的影响。
在初潮年龄（<14、14-17 和 >17 岁）的各个类别中，糖尿病的多变量校正比值比分别为 1.22（95%置信区间[CI]：1.17，1.28）、1.00（参考）和 0.89（95%CI：0.85，0.93）。在亚组分析中，在总胆固醇/血压水平与初潮年龄之间检测到糖尿病风险的显著交互作用（交互作用 P 值分别为.0091 和.0019）。在总胆固醇/血压水平与初潮年龄之间检测到糖尿病风险的显著交互作用（交互作用 P 值分别为.0091 和.0019）。在总胆固醇/血压水平与初潮年龄之间检测到糖尿病风险的显著交互作用（交互作用 P 值分别为.0091 和.0019）。在总胆固醇/血压水平与初潮年龄之间检测到糖尿病风险的显著交互作用（交互作用 P 值分别为.0091 和.0019）。在总胆固醇/血压水平与初潮年龄之间检测到糖尿病风险的显著交互作用（交互作用 P 值分别为.0091 和.0019）。在总胆固醇/血压水平与初潮年龄之间检测到糖尿病风险的显著交互作用（交互作用 P 值分别为.0091 和.0019）。在初潮年龄<14 岁的参与者中观察到与初潮年龄相关的风险增加，但在初潮年龄≥14 岁的参与者中未观察到这种风险增加（交互作用 P 值为<.0001）。
在中国女性中，初潮年龄与成年后糖尿病风险呈负相关，且似乎受到 ICVHMs 的影响。需要进一步的研究来阐明两者之间的确切关系和我们研究结果的普遍性。
