Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, South Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 04514, South Korea.
J Clin Endocrinol Metab. 2022 May 17;107(6):e2309-e2317. doi: 10.1210/clinem/dgac068.
The association of menstrual cycle length and irregularity with the risk of non-alcoholic fatty liver disease (NAFLD) is unknown.
We examined this association in large cross-sectional and cohort studies.
The cross-sectional study included 72 092 women younger than 40 years who underwent routine health examinations; the longitudinal analysis included the subset of 51 118 women without NAFLD at baseline. Long or irregular cycles were defined as menstrual cycles of 40 days or longer or too irregular to estimate. Abdominal ultrasonography was performed to identify NAFLD. Multivariable Cox proportional hazard regression analyses were performed to estimate hazard ratios (HRs) and 95% CIs for incident NAFLD according to menstrual cycle regularity and length, with 26- to 30-day cycles as the reference.
At baseline, 27.7% had long or irregular menstrual cycles and 7.1% had prevalent NAFLD. Long or irregular menstrual cycles were positively associated with prevalent NAFLD. During a median follow-up of 4.4 years, incident NAFLD occurred in 8.9% of women. After adjustment for age, body mass index, insulin resistance, and other confounders, the multivariable-adjusted HR for NAFLD comparing long or irregular menstrual cycles to the reference group was 1.22 (95% CI, 1.14-1.31); this association strengthened in the time-dependent analysis with an HR of 1.49 (95% CI, 1.38-1.60).
Long or irregular menstrual cycles were associated with increased risk of both prevalent and incident NAFLD in young, premenopausal women. Women with long or irregular menstrual cycles may benefit from lifestyle modification advice to reduce the risk of NAFLD and associated cardiometabolic diseases.
月经周期长度和不规律与非酒精性脂肪性肝病（NAFLD）风险的关联尚不清楚。
我们在大型横断面和队列研究中检查了这种关联。
横断面研究纳入了 72092 名年龄小于 40 岁接受常规健康检查的女性；纵向分析包括基线时无 NAFLD 的 51118 名女性亚组。长周期或不规律周期定义为周期为 40 天或更长时间，或周期不规则无法估算。腹部超声用于识别 NAFLD。多变量 Cox 比例风险回归分析用于估计根据月经周期规律和长度发生的 NAFLD 的风险比（HR）和 95%置信区间（CI），以 26-30 天周期为参考。
基线时，27.7%的女性存在长周期或不规律周期，7.1%的女性存在现患 NAFLD。长周期或不规律周期与现患 NAFLD 呈正相关。在中位随访 4.4 年期间，8.9%的女性发生了新发 NAFLD。在调整年龄、体重指数、胰岛素抵抗和其他混杂因素后，与参考组相比，长周期或不规律周期发生 NAFLD 的多变量调整 HR 为 1.22（95%CI，1.14-1.31）；随着时间的推移进行分析，这种关联增强，HR 为 1.49（95%CI，1.38-1.60）。
在年轻的绝经前女性中，长周期或不规律周期与现患和新发 NAFLD 的风险增加相关。长周期或不规律周期的女性可能受益于生活方式改变建议，以降低 NAFLD 和相关心血管代谢疾病的风险。
