早初潮对青春晚期及中年期肥胖的远期影响

目的分析女性初潮年龄（MA）对青春晚期（LP）和中年期（ML）肥胖的远期影响。方法以北京市儿童青少年代谢综合征（BCAMS）研究样本中16～18岁女性（2035人）为LP研究人群，以“宫内发育与成人疾病”队列人群中41～52岁女性（479人）为ML研究人群。以体重指数（BMI）和腰围身高比（WHtR）评价肥胖和中心性肥胖；以LP、ML各自MA的P25和P75将两人群分别划分为早、中、晚初潮组；分别以中国学龄儿童和中国成年人BMI标准作为两人群超重和肥胖的诊断标准，以WHtR≥0．5定义中心性肥胖；多元线性回归和logistic回归分析MA与BMI和WHtR相关关系，以及早初潮预测LP和ML肥胖的比值比（OR）。结果LP和ML人群的肥胖率、中心性肥胖率均随初潮年龄提前而上升（χ^2趋势检验，P值均〈0．001）；初潮年龄每提前1岁，LP和ML女性的BMI分别增加0．58kg／m^2和0．35kg／m^2，腰围分别增加1．1cm和0．6cm；与晚初潮者相比，早初潮者在LP和ML发生肥胖的OR值分别是8．740（95％CI：3．653～20．911）和2．498（1．145～5．453），中心性肥胖的OR值分别是14．280（3．223～63．267）和15．604（1．821～133．679）。结论月经初潮相对较早的女性在LP和ML更趋向于发生肥胖，特别是中心性肥胖。

Impact of early menarche on adiposity during late puberty and mid-life

OBJECTIVE: To evaluate the impact of menarche age (MA) on obese status in late puberty (LP) and mid-life (ML) females. METHODS: 2035 girls aged 16 to 18 years were selected from a Beijing Child and Adolescent Metabolic Syndrome (BCAMS) study, which was performed from April to October in 2004, as the LP study population. 479 women aged 41 to 52 years were from the Fetal Origin of Adult Disease (FOAD) cohort, which established in 1995 to 2001, as the ML study population. Based on the 25 and 75 percentile of MA of each population, all subjects of LP and ML were divided into early, middle, and late matured groups, respectively. Overweight and obesity were defined by Chinese age-, gender-specific BMI criteria for LP girls, and Chinese BMI criteria for ML women while central obesity was defined by the waist-to-height ratio (WHtR) cutoff of 0.5. Multiple linear regression was used to explore the associations between MA and BMI, waist circumference (WC) and WHtR. The impact of early menarche on obese status in late life was estimated by odds ratio (OR) using logistic regression analyses. RESULTS: The prevalence of overweight and obesity increased with the decrease of MA in both LP and ML population. When MA had a one-year advance, a 0.58 kg/m2 increase in BMI and a 1.1 cm increase in WC during LP, and a 0.35 kg/m2 increase in BMI and a 0.6 cm increase in WC during ML were observed. After adjustment for age, residence area and life style related variables, those who experienced earlier menarche were at higher risk of suffering from obesity in LP (OR :8.740, 95% CI: 3.653-20.911) and during ML (2.498, 1.145-5.453) when compared to those with later menarche. We also noticed that the risk increased for central obesity [LP: 14.280 (3.223-63. 267), ML: 15.604 (1.821-133.679)]. CONCLUSION: Menarche age appeared to be an independent predictor for obese status in LP and ML among women.