Centre for Longitudinal and Lifecourse Research, School of Public Health, The University of Queensland, 266 Herston Rd, Brisbane, QLD 4006, Australia.
Centre for Longitudinal and Lifecourse Research, School of Public Health, The University of Queensland, 266 Herston Rd, Brisbane, QLD 4006, Australia.
Maturitas. 2022 May;159:52-61. doi: 10.1016/j.maturitas.2022.01.001. Epub 2022 Jan 11.
This study examined the association between reproductive lifespan and incident type 2 diabetes mellitus (T2DM) and hypertension in mid-age women. Also, the combined effect of reproductive lifespan and body mass index (BMI) on the risks of T2DM and hypertension were explored.
Reproductive lifespan was defined as the difference between age at menopause and age at menarche, and categorized as <35, 35-37, 38-40, and ≥41 years based on the quartile distribution. A multivariable Cox proportional hazard regression was used, adjusting for socio-demographic, lifestyle, and reproductive factors.
Of 6357 postmenopausal women included (mean [SD] age at last follow-up, 66.3[3.3] years), a total of 655 developed incident T2DM (10.3%) and 1741 developed hypertension (30.0%) during 20 years of follow-up. The total sample had a mean (SD) reproductive lifespan of 37.9 (4.5). Compared with the women who had a reproductive lifespan of 38-40 years, those with a short reproductive lifespan (<35 years) had a 30% increased risk of T2DM and twice the risk of hypertension. Under the combined model, women who had a short reproductive lifespan (<35 years) and who had a BMI ≥30 kg/m at baseline showed a higher risk of T2DM (HR: 6.30, 95% CI: 4.41-8.99) and hypertension (HR: 6.06, 4.86-7.55) compared with women who had a reproductive lifespan of 38-40 years and a BMI < 25 kg/m.
A higher risk of both incident T2DM and hypertension at midlife was found among women experiencing a shorter reproductive lifespan, with pronounced risk for women experiencing both a short reproductive lifespan (<35 years) and a higher baseline BMI (≥30 kg/m). Women with a short reproductive lifespan may benefit from maintaining healthy body weight in midlife.
本研究旨在探讨中年女性生殖寿命与 2 型糖尿病（T2DM）和高血压发病的关系，并探讨生殖寿命与体重指数（BMI）联合对 T2DM 和高血压发病风险的影响。
生殖寿命定义为绝经年龄与初潮年龄之差，并根据四分位分布将其分为<35、35-37、38-40 和≥41 年。采用多变量 Cox 比例风险回归模型，调整了社会人口统计学、生活方式和生殖因素。
在纳入的 6357 名绝经后妇女中（末次随访时的平均[标准差]年龄为 66.3[3.3]岁），共有 655 人在 20 年的随访中发生了 T2DM（10.3%），1741 人发生了高血压（30.0%）。总样本的生殖寿命平均（标准差）为 37.9（4.5）年。与生殖寿命为 38-40 年的女性相比，生殖寿命较短（<35 年）的女性发生 T2DM 的风险增加 30%，发生高血压的风险增加两倍。在联合模型中，生殖寿命较短（<35 年）且基线 BMI≥30kg/m 的女性发生 T2DM 的风险更高（HR：6.30，95%CI：4.41-8.99）和高血压（HR：6.06，4.86-7.55）与生殖寿命为 38-40 年且 BMI<25kg/m 的女性相比。
生殖寿命较短的中年女性发生 T2DM 和高血压的风险均较高，生殖寿命较短（<35 年）且基线 BMI 较高（≥30kg/m）的女性风险更为显著。生殖寿命较短的女性可能受益于维持中年健康体重。
