Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
JAMA Netw Open. 2022 Mar 1;5(3):e221256. doi: 10.1001/jamanetworkopen.2022.1256.
Emerging data suggest that more than two-thirds of premenstrual disorders (PMDs), including premenstrual syndrome and premenstrual dysphoric disorder, have symptom onset during the teen years. Adulthood adiposity has been associated with PMDs; however, the association with childhood and adolescent body size is unknown.
To examine the association between childhood and adolescent body size and risk of PMDs in young adulthood.
DESIGN, SETTING, AND PARTICIPANTS: This prospective cohort study included 6524 US female participants from the Growing Up Today Study (1996-2013). Data were analyzed from February 26, 2020, to June 23, 2021.
Body mass index (BMI) was estimated using self-reported height and weight through adolescence and converted to BMI for age (z score).
In 2013, premenstrual symptoms and identified PMDs were assessed with a validated scale based on the Calendar of Premenstrual Experiences. The associations of BMI for age with PMDs and premenstrual symptoms were examined using log-binomial and linear regressions, respectively.
Among 6524 participants (mean [SD] age, 26 [3.5] years; 6108 [93.6%] White), 1004 (15.4%) met the criteria for a PMD. Baseline BMI for age reported at a mean (SD) age of 12.7 (1.1) years was associated with increased risk of PMDs (confounding-adjusted relative risk, 1.09 per unit of z score; 95% CI, 1.03-1.15) and higher burden of premenstrual symptoms (β = 0.06; 95% CI, 0.04-0.08). Associations were particularly pronounced for premenstrual dysphoric disorder and for PMDs with symptom onset before 20 years of age and remained in the absence of psychiatric comorbidities, including depression, anxiety, and disordered eating behavior. When analyzing BMI change over time, individuals with high BMI throughout adolescence had a higher burden of premenstrual symptoms (β = 0.17; 95% CI, 0.08-0.27) compared with those with normal BMI throughout adolescence. Individuals with high BMI early followed by a mild decrease later did not report higher premenstrual symptoms (β = 0.06; 95% CI, 0.00-0.12).
In this cohort study, childhood body size was associated with PMD risk and premenstrual symptoms in young adulthood. These findings suggest that maintaining a normal body mass in childhood may be considered for lowering the burden of PMDs in adulthood.
新出现的数据表明，包括经前综合征和经前烦躁障碍在内的超过三分之二的经前障碍（PMD）在青少年时期开始出现症状。成年肥胖与 PMD 有关；然而，与儿童和青少年时期的身体大小的关联尚不清楚。
研究儿童和青少年时期的身体大小与青年期 PMD 风险之间的关系。
设计、地点和参与者：这是一项前瞻性队列研究，包括来自美国今日成长研究（1996-2013 年）的 6524 名女性参与者。数据分析于 2020 年 2 月 26 日至 2021 年 6 月 23 日进行。
通过青春期自我报告的身高和体重估算体重指数（BMI），并转换为年龄 BMI（z 分数）。
在 2013 年，根据经前期经验日历，使用经过验证的量表评估经前期症状和确定的 PMD。使用对数二项式和线性回归分别检查 BMI 与 PMD 和经前期症状的关联。
在 6524 名参与者（平均[标准差]年龄 26[3.5]岁；6108[93.6%]为白人）中，有 1004 名（15.4%）符合 PMD 标准。在平均（标准差）年龄为 12.7（1.1）岁时报告的基线 BMI 与 PMD 风险增加相关（混杂调整后的相对风险，每单位 z 分数增加 1.09；95%置信区间，1.03-1.15），并且经前期症状负担更高（β=0.06；95%置信区间，0.04-0.08）。对于经前烦躁障碍和症状在 20 岁之前出现的 PMD，关联尤其明显，并且在没有精神共病（包括抑郁、焦虑和饮食失调行为）的情况下仍然存在。当分析 BMI 随时间的变化时，整个青春期 BMI 较高的个体经前期症状负担更高（β=0.17；95%置信区间，0.08-0.27），而整个青春期 BMI 正常的个体则无此负担。早期 BMI 较高随后轻度下降的个体报告的经前期症状没有更高（β=0.06；95%置信区间，0.00-0.12）。
在这项队列研究中，儿童时期的身体大小与青年期 PMD 风险和经前期症状有关。这些发现表明，在儿童时期保持正常体重可能有助于降低成年期 PMD 的负担。
