女性月经初潮年龄与糖尿病前期及2型糖尿病的关系研究

摘要

目的：探讨女性月经初潮年龄与糖尿病前期及2型糖尿病的关系。方法以2011年4—11月中华医学会内分泌分会发起的“中国二十个社区糖尿病患者肿瘤发生风险的流行病学调查（泸州地区）”为基础，选取其中年龄＞40岁的女性受试者为研究对象。比较不同月经初潮年龄受试者的糖尿病前期和2型糖尿病患病率，并探讨女性月经初潮年龄对糖尿病患病的影响。结果最终纳入受试者3966例，平均月经初潮年龄为（14．8±1．8）岁。不同月经初潮年龄受试者的腰围和收缩压比较，差异有统计学意义（ P ＜0．05）；而平均年龄、 BMI、舒张压、空腹血糖（FPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL－C）、高密度脂蛋白胆固醇（HDL－C）比较，差异无统计学意义（P＞0．05）。不同月经初潮年龄受试者的糖尿病前期、2型糖尿病患病率比较，差异无统计学意义（P＞0．05）。调整BMI后，不同月经初潮年龄正常、超重、肥胖受试者的糖尿病前期患病率比较，差异均无统计学意义（P＞0．05）；不同月经初潮年龄正常受试者的2型糖尿病患病率比较，差异有统计学意义（P＜0．05）；不同月经初潮年龄超重、肥胖受试者的2型糖尿病患病率比较，差异无统计学意义（P＞0．05）。多因素Logistic回归分析结果显示，年龄、 TC、 TG、 LDL－C、 HDL－C是女性患2型糖尿病的影响因素（P＜0．05）；月经初潮年龄对女性患2型糖尿病的影响无统计学意义（P＞0．05），但月经初潮年龄每增加1岁，2型糖尿病患病风险减少3．8％〔OR （95％CI）＝0．963（0．902，1．008）〕。结论月经初潮年龄不是女性患糖尿病前期及2型糖尿病的影响因素，但月经初潮年龄过早可能会增加2型糖尿病的患病风险。%Objective To study the relationship between female menarche age and prediabetes and type 2 diabetes mellitus.Methods Based on the "epidemiological investigation of risk of cancer of diabetic patients in twenty communities of China (Luzhou Region)"launched by Endocrinology branch of Chinese Medical Association from April to November, 2011, women aged over 40 were selected as the research objects.The prevalence rate of prediabetes and of type 2 diabetes mellitus of subjects at different menarche ages were compared, and the influence of female menarche age on the risk of diabetes was investigated.Results Finally 3 966 subjects were enrolled with an average menarche age of ( 14.8 ±1.8 ) .There was significant difference in the waistline and systolic blood pressure of the subjects at different menarche ages (P<0.05); while no significant differences were found in the average age, BMI, diastolic blood pressure, fasting plasma glucose ( FPG ) , 2 h postprandial plasma glucose (2 hPG), glycosylated hemoglobin (HbA1c), total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C, P>0.05) .The prevalence rate of prediabetes and type 2 diabetes mellitus of subjects at different menarche ages showed no significant differences ( P>0.05 ) . After adjusting BMI, there was no significant difference in the prevalence rate of prediabetes at the different menarche ages among normal weight subjects, overweight subjects and obese subjects ( P>0.05 ); there was significant difference in the prevalence rate of type 2 diabetes mellitus at the different menarche ages of subjects with normal BMI ( P<0.05); there was no significant difference in the prevalence rate of type 2 diabetes mellitus at the different menarche ages between overweight subjects and obese subjects (P>0.05) .Multivariate Logistic regression analysis results showed that age, TC, TG, LDL-C, HDL-C significantly affected the risk of type 2 diabetes mellitus in females ( P <0.05 ); the female menarche age had no significant effects on developing type2 diabetes mellitus ( P>0.05 ) , but the risk of developing type 2 diabetes mellitus decreased by 3.8% as the menarche age increased every one year 〔OR (95%CI) =0.963 (0.902, 1.008)〕 .Conclusion The menarche age is not the influencing factors of females developingpre diabetes and type 2 diabetes mellitus, but premature menarche may increase the risk of having type 2 diabetes mellitus.