中老年女性初潮年龄与高尿酸血症的关系及BMI的中介作用

Association between age at menarche and hyperuricemia in middle-aged and elderly women and the mediating effect of body mass index

摘要:

目的 探讨中老年女性月经初潮年龄与高尿酸血症（hyperuricemia，HUA）患病的关系以及体质指数（body mass index，BMI）的介导作用。方法 以中国健康与养老追踪调查前瞻性研究项目2011年和2015年调查中，具有完整月经初潮与尿酸等信息的5 322名年龄≥45岁女性为研究对象。采用多因素logistic回归模型分析初潮年龄对HUA的影响，采用限制性立方样条函数分析初潮年龄与HUA的关系类型。通过中介分析探讨BMI在初潮年龄与HUA关系中的作用。结果 在5 322名女性中，274名（5.15%）患有HUA。调整混杂因素后，与月经初潮为8~13岁的女性相比，16~17岁及18~22岁组HUA的比值比（odds ratio，OR）与95%置信区间（confidence interval，CI）分别为0.643（0.429，0.964）、0.634（0.411，0.979）。初潮年龄与HUA存在线性负相关，初潮年龄每增加1岁，HUA风险降低6%。BMI部分介导了年龄和HUA的关系，直接效应和间接效应的OR与95%CI分别为0.936（0.878，0.999）和0.992（0.987，0.997）。结论 较晚的初潮年龄可降低HUA患病风险，初潮年龄过早与HUA风险增加相关。BMI在月经初潮年龄与HUA的关系中起部分中介作用。

Abstract:

Objective To explore the relationship between menarche age and hyperuricemia（HUA） in middle-aged and elderly women and whether this relationship is mediated by body mass index（BMI）.Methods A total of 5 322 women aged ≥45 who had complete data on menarche and uric acid in the China Health and Retirement Longitudinal Study， a prospective study project from 2011 and 2015，were enrolled in this study. Multivariate logistic regression analysis was used to analyze the effect of menarche age on HUA， and restricted cubic spline based on logistic regression was used to analyze the relationship between menarche age and HUA. Mediation analysis was performed to explore the contribution of BMI to the association between age at menarche and HUA.Results Among 5 322 women，274（5.15%） had HUA. When compared with women aged 8 to 13 at menarche， the OR value and 95% confidence interval（CI） of HUA in 16-17 years and 18-22 years groups were 0.643（0.429，0.964） and 0.634（0.411，0.979），respectively，after adjusting for potential confounding factors. There was a linear inverse correlation between age at menarche and HUA，and the risk of HUA decreased by 6% for each 1-year increase of age at menarche. BMI partially mediated the association between menarche age and HUA，and the OR and 95%CI of direct effect and indirect effect were 0.936（0.878， 0.999） and 0.992（0.987，0.997），respectively.Conclusion Late menarche age reduces the risk of HUA，and early age at menarche is associated with an increased risk of HUA. BMI partially mediates the association between age at menarche and the risk of HUA.