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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P_(25)和P_(75)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(X~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0.58 kg/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。
Objective To analyze the long-term effects of female menarche age (MA) on obesity in late adulthood (LP) and middle age (ML). Methods A total of 2035 women aged 16-18 years from Beijing Children and Adolescent Metabolic Syndrome (BCAMS) were enrolled in this study. A cohort of 41-52-year-old women (479) with a cohort of “intrauterine growth and adult disease” People) for the ML study population. Body mass index (BMI) and waist circumference ratio (WHtR) were used to evaluate obesity and central obesity. The two groups were divided into early, middle and late menarche groups respectively by P_ (25) and P_ (75) Respectively, the Chinese school-age children and adults in China BMI standards for the diagnosis of overweight and obesity in both populations, with a WHtR ≥ 0.5 defined central obesity; multiple linear regression and logistic regression analysis of the correlation between MA and BMI and WHtR, and early menarche prediction LP And ML obesity odds ratio (OR). Results The prevalence of obesity and central obesity in LP and ML population both increased with the advance of menarche age (P <0.001). The age of menarche was 1 year earlier, and the BMI of LP and ML women increased by 0.58 kg / m ~ 2 and 0.35kg / m ~ 2, waist circumference increased by 1.1cm and 0.6cm, respectively. Compared with late menarche, the odds of obesity in LP and ML were 8.740 (95% CI: 3.653 ~ 20.911) and 2.498 (1.145 ~ 5.453) respectively. The OR of central obesity were 14.280 (3.223 ~ 63.267) and 15.604 (1.821 ~ 133.679), respectively. Conclusions Women with relatively early menarche tend to develop obesity in LP and ML, especially central obesity.