肥胖在藏族绝经前女性初潮年龄与血压关系中的中介作用  

Obesity mediates the association between age at menarche and blood pressure among premenopausal Tibetan women in China

作　　者：李可晗 尼玛曲措[2] 张强[2] 何瑞峰[2] 拉巴次仁 赵颖 陈佳怡 张铭 杨瑞希 李景中[2] 刘巧兰[1] LI Ke-han;NIMA Qu-cuo;ZHANG Qiang;HE Rui-feng;LABA Ci-ren;ZHAO Ying;CHEN Jia-yi;ZHANG Ming;YANG Rui-xi;LI Jing-zhong;LIU Qiao-lan(Department of Health Behavior and Social Medicine,West China School of Public Health,Sichuan University/West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China;不详)

机构地区：[1]四川大学华西公共卫生学院健康行为与社会医学系/四川大学华西第四医院,四川成都610041 [2]西藏自治区疾病预防控制中心

出　　处：《现代预防医学》2023年第1期10-14,144,共6页Modern Preventive Medicine

基　　金：国家重点研发计划(2017YFC0907302);四川大学校级项目(2021skzx-pt74)。

摘　　要：目的 探讨高原藏族绝经前女性初潮年龄与成年后肥胖、血压的关系,以及肥胖对初潮年龄和血压关联的中介作用。方法 以西南区域自然人群队列基线调查中的2 337名藏族绝经前女性为研究对象,采用多元线性回归分析初潮年龄对成年期肥胖和血压的影响,采用因果逐步回归法和类贝叶斯蒙特卡罗近似法来估计中介效应。结果 调查对象平均年龄为(40.19±9.91)岁,平均初潮年龄为(15.13±1.87)岁。初潮年龄每提前1岁,BMI增加0.183 kg/m2(P<0.001),腰臀比增加0.003(P<0.001),收缩压升高0.438 mm Hg(P=0.006),舒张压升高0.373 mm Hg(P=0.001)。BMI和腰臀比部分介导了初潮年龄和收缩压之间的关系(间接效应分别占25.3%和11.2%),同样也部分介导了初潮年龄和舒张压之间的关系(间接效应分别占25.3%和15.0%)。结论 月经初潮过早是女性成年后发生肥胖和高血压的危险因素;肥胖是初潮年龄与血压之间关系的重要中介因素。对初潮年龄早且肥胖的女性可施加适当的干预措施有助于降低未来高血压的发病率。Objective To investigate the relationship between age at menarche and obesity and blood pressure in premenopausal Tibetan women, and the mediating effect of obesity on the association between age at menarche and blood pressure. Methods 2 337 premenopausal Tibetan women in Lhasa from the baseline survey of China’s multi-ethnic cohort were included in this study. Multiple linear regression was conducted to analyze the effect of age at menarche on adult obesity and blood pressure. Stepwise multiple regression and quasi-Bayesian approximation were adopted to estimate the mediating effects. Results The mean age of the subjects was(40.19±9.91) years and the mean age at menarche was(15.13±1.87) years. For every 1-year earlier age at menarche, BMI increased 0.183 kg/m~2(P<0.001), waist-to-hip ratio 0.003(P<0.001), systolic blood pressure 0.438 mm Hg(P=0.006), and diastolic blood pressure 0.373 mm Hg(P=0.001). BMI and waist-to-hip ratio partially mediated the relationship between age at menarche and systolic blood pressure(indirect effects of 25.3% and 11.2%, respectively), and similarly partially mediated the relationship between age at menarche and diastolic blood pressure(indirect effects of 25.3% and 15.0%, respectively). Conclusion Early age at menarche is associated with obesity and hypertension in adulthood, and obesity is an important mediator of the relationship between age at menarche and blood pressure. Women with early menarche and obesity should be targeted with appropriate interventions to reduce the future incidence of hypertension.

关 键 词：藏族女性 初潮年龄 肥胖 血压 中介效应 

分 类 号：R173[医药卫生—妇幼卫生保健]