Gupta Ishita, Kondal Dimple, Mohan Sailesh, Deepa Mohan, Anjana Ranjit M, Ali Mohammed K, Narayan K M Venkat, Mohan Viswanathan, Tandon Nikhil, Prabhakaran Dorairaj, Patel Shivani A
Centre for Chronic Disease Control, Delhi, 110016, India.
Public Health Foundation of India, Delhi, 110030, India.
Int J Epidemiol. 2025 Apr 12;54(3). doi: 10.1093/ije/dyaf049.
Early onset of menarche is associated with hormonal alterations that may predispose women to diabetes. We investigated the association between age at menarche and incident diabetes in India, a setting with declining menarche age and increasing burden of diabetes.
Data were from the Cardiometabolic Risk Reduction in South Asia study. Women free of diabetes at baseline (2010-12) were followed until 2021 for incident diabetes, defined as prior medical diagnosis or fasting plasma glucose ≥126 mg/dl or HbA1c ≥6.5%. Age at menarche, in years was collected through self-report. Multivariable Cox proportional hazards regression models, controlling for socio-demographic factors and potentially confounding clinical parameters, estimated the association [hazard ratio (HR)] of menarche age with incident diabetes. Effect modification by obesity status was also assessed.
Of 3654 women at risk of diabetes at baseline, mean age was 37.7 [Standard Deviation (SD) = 10.4] years and mean age of menarche was 13.9 (SD = 1.3) years. Younger women (age 20-39 years) had an earlier onset of menarche compared to older women. Over 11 years of follow-up (median: 9.2 years), we observed 390 cases of diabetes [cumulative incidence (CI): 10.7%, 95% CI 9.32-12.33; incidence rate: 12.4 per 1000 person-years (95% CI 11.23-13.69)]. There was no association between age at menarche and incident diabetes, HR = 1.04 (95% CI 0.95-1.14). The null association was consistent in models stratified by obesity status.
We did not find evidence of an association between age at menarche and incident diabetes in this large cohort of Indian women.
月经初潮过早与激素变化有关，这可能使女性易患糖尿病。我们在印度调查了月经初潮年龄与新发糖尿病之间的关联，印度的月经初潮年龄呈下降趋势，糖尿病负担不断增加。
数据来自南亚降低心血管代谢风险研究。对基线时（2010 - 12年）无糖尿病的女性进行随访，直至2021年观察新发糖尿病情况，新发糖尿病定义为先前的医学诊断或空腹血糖≥126mg/dl或糖化血红蛋白≥6.5%。月经初潮年龄通过自我报告收集。多变量Cox比例风险回归模型在控制社会人口学因素和潜在混杂临床参数的情况下，估计月经初潮年龄与新发糖尿病的关联[风险比（HR）]。还评估了肥胖状态的效应修饰作用。
在基线时有糖尿病风险的3654名女性中，平均年龄为37.7岁[标准差（SD）=10.4]，月经初潮平均年龄为13.9岁（SD = 1.3）。与年龄较大的女性相比，年龄较小的女性（20 - 39岁）月经初潮开始得更早。在超过11年的随访中（中位数：9.2年），我们观察到390例糖尿病病例[累积发病率（CI）：10.7%，95%CI 9.32 - 12.33；发病率：每1000人年12.4例（95%CI 11.23 - 13.69）]。月经初潮年龄与新发糖尿病之间无关联，HR = 1.04（95%CI 0.95 - 1.14）。在按肥胖状态分层的模型中，这种无关联的结果是一致的。
在这一大群印度女性中，我们没有发现月经初潮年龄与新发糖尿病之间存在关联的证据。
