Division of Human Nutrition and Health, Wageningen University and Research, Stippeneng 4, 6708, WE, Wageningen, the Netherlands.
BMC Public Health. 2022 Mar 31;22(1):628. doi: 10.1186/s12889-022-12995-3.
In western countries, age at menarche (AAM) is nowadays lower than a century ago, coinciding with increased Body Mass Index (BMI) and prevalence of non-communicable diseases (NCD). This study aimed to determine the time trend in AAM, and its association with BMI and NCD prevalence at later age, in Indonesia.
We used secondary data of 15,744 women aged 15-65 years from the Indonesian Family Life Survey (IFLS) conducted in the period 1993 to 2015. Multiple linear regression was applied to determine the association of AAM with BMI, and Poisson regression with robust variance for investigating the association of AAM with NCD prevalence ratios. Models were adjusted for age, and effect modification by wealth status, living area, and region was investigated.
AAM has significantly declined from 14.4 (SD:2.1) years of age in the 1940s to 13.4 y (SD:1.5) in the 1990s. AAM was inversely associated with BMI (β: - 0.30 kg/m, 95%CI: - 0.37, - 0.22) and body weight (β: - 0.67 kg, 95%CI: - 0.75, - 0.54), but was not associated with height. After adjustment for age, AAM was not associated with NCD, i.e. hypertension, type 2 diabetes mellitus, liver diseases, asthma, chronic lung diseases, cardiovascular diseases, stroke, cancer, or arthritis. Including BMI in the models did not change the results.
From the 1940s to 1990s, AAM has declined with 1 year in Indonesia. Women with earlier AAM had higher BMI and body weight at later age, but AAM was not associated with NCD prevalence in later life in the Indonesian population. Further longitudinal research is needed to disentangle the direction of causality of the associations.
在西方国家，初潮年龄（AAM）如今比一个世纪前要低，这与体重指数（BMI）的增加和非传染性疾病（NCD）的流行有关。本研究旨在确定印度尼西亚 AAM 的时间趋势，及其与 BMI 和较晚年龄 NCD 患病率的关系。
我们使用了 1993 年至 2015 年期间进行的印度尼西亚家庭生活调查（IFLS）中 15744 名 15-65 岁女性的二级数据。我们应用多元线性回归来确定 AAM 与 BMI 的关系，应用泊松回归并使用稳健方差来研究 AAM 与 NCD 患病率比值的关系。模型调整了年龄，还调查了财富状况、居住区域和地区的效应修饰作用。
AAM 从 20 世纪 40 年代的 14.4（SD：2.1）岁显著下降到 20 世纪 90 年代的 13.4 岁。AAM 与 BMI（β：-0.30kg/m，95%CI：-0.37，-0.22）和体重（β：-0.67kg，95%CI：-0.75，-0.54）呈负相关，但与身高无关。在调整年龄后，AAM 与 NCD 无关，即高血压、2 型糖尿病、肝脏疾病、哮喘、慢性肺部疾病、心血管疾病、中风、癌症或关节炎。在模型中纳入 BMI 并未改变结果。
从 20 世纪 40 年代到 90 年代，AAM 在印度尼西亚下降了 1 岁。初潮较早的女性在较晚年龄时 BMI 和体重较高，但 AAM 与印度尼西亚人群较晚年龄 NCD 患病率无关。需要进一步的纵向研究来理清这些关联的因果关系方向。
