Age at menarche, ideal cardiovascular health metrics, and risk of diabetes in adulthood: Findings from the REACTION study

Chunyan Hu; Yi Zhang; Jie Zhang; Yanan Huo; Qin Wan; Mian Li; Hongyan Qi; Rui Du; Yuanyue Zhu; Yingfen Qin; Ruying Hu; Lixin Shi; Qing Su; Xuefeng Yu; Li Yan; Guijun Qin; Xulei Tang; Gang Chen; Min Xu; Tiange Wang; Zhiyun Zhao; Yuhong Chen; Zhengnan Gao; Guixia Wang; Feixia Shen; Zuojie Luo; Li Chen; Qiang Li; Zhen Ye; Yinfei Zhang; Chao Liu; Youmin Wang; Shengli Wu; Tao Yang; Huacong Deng; Lulu Chen; Jiajun Zhao; Yiming Mu; Weiqing Wang; Yu Xu; Yufang Bi; Jieli Lu; Guang Ning; REACTION Study Group

doi:10.1111/1753-0407.13128

Age at menarche, ideal cardiovascular health metrics, and risk of diabetes in adulthood: Findings from the REACTION study

J Diabetes. 2021 Jun;13(6):458-468. doi: 10.1111/1753-0407.13128. Epub 2020 Dec 29.

Authors

Chunyan Hu^{1

2}, Yi Zhang^{1

2}, Jie Zhang^{1

2}, Yanan Huo³, Qin Wan⁴, Mian Li^{1

2}, Hongyan Qi^{1

2}, Rui Du^{1

2}, Yuanyue Zhu^{1

2}, Yingfen Qin⁵, Ruying Hu⁶, Lixin Shi⁷, Qing Su⁸, Xuefeng Yu⁹, Li Yan¹⁰, Guijun Qin¹¹, Xulei Tang¹², Gang Chen¹³, Min Xu^{1

2}, Tiange Wang^{1

2}, Zhiyun Zhao^{1

2}, Yuhong Chen^{1

2}, Zhengnan Gao¹⁴, Guixia Wang¹⁵, Feixia Shen¹⁶, Zuojie Luo⁵, Li Chen¹⁷, Qiang Li¹⁸, Zhen Ye⁶, Yinfei Zhang¹⁹, Chao Liu²⁰, Youmin Wang²¹, Shengli Wu²², Tao Yang²³, Huacong Deng²⁴, Lulu Chen²⁵, Jiajun Zhao²⁶, Yiming Mu²⁷, Weiqing Wang^{1

2}, Yu Xu^{1

2}, Yufang Bi^{1

2}, Jieli Lu^{1

2}, Guang Ning^{1

2}; REACTION Study Group

Affiliations

¹ Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
² Shanghai National Clinical Research Center for Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
³ Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China.
⁴ The Affiliated Hospital of Luzhou Medical College, Luzhou, China.
⁵ The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
⁶ Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
⁷ Affiliated Hospital of Guiyang Medical College, Guiyang, China.
⁸ Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
⁹ Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹⁰ Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
¹¹ The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
¹² The First Hospital of Lanzhou University, Lanzhou, China.
¹³ Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China.
¹⁴ Dalian Municipal Central Hospital, Dalian, China.
¹⁵ The First Hospital of Jilin University, Changchun, China.
¹⁶ The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
¹⁷ Qilu Hospital of Shandong University, Jinan, China.
¹⁸ The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
¹⁹ Central Hospital of Shanghai Jiading District, Shanghai, China.
²⁰ Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China.
²¹ The First Affiliated Hospital of Anhui Medical University, Hefei, China.
²² Karamay Municipal People's Hospital, Xinjiang, China.
²³ The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
²⁴ The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
²⁵ Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
²⁶ Shandong Provincial Hospital affiliated to Shandong University, Jinan, China.
²⁷ Chinese People's Liberation Army General Hospital, Beijing, China.

PMID: 33135296
DOI: 10.1111/1753-0407.13128

Abstract
in English, Chinese

Background: Age at menarche was reported to be associated with the risk of diabetes. However, the impact of ideal cardiovascular health metrics (ICVHMs) on the association between age at menarche and adulthood diabetes risk was unclear.

Methods: We included 121 431 women from the nationwide, population-based cohort of the REACTION study (Risk Evaluation of Cancers in Chinese Diabetic Individuals: a Longitudinal Study). The diagnosis of diabetes was based on the oral glucose tolerance test (OGTT) and glycosylated hemoglobin (HbA1c) measurement. Logistic regression and multiplicative interaction analysis were conducted to investigate the potential interaction effect between age at menarche and ICVHMs on the development of diabetes.

Results: The multivariable-adjusted odds ratios of diabetes across categories of age at menarche (<14, 14-17, and > 17 years) were 1.22 (95% confidence interval [CI]: 1.17, 1.28), 1.00 (reference), and 0.89 (95% CI: 0.85, 0.93), respectively. In subgroup analysis, significant interactions were detected between total cholesterol/blood pressure levels and age at menarche regarding the risk of diabetes (P for interaction = .0091 and .0019, respectively). The increased risk associated with age at menarche <14 years was observed in participants with three or fewer ICVHMs, but not in women with four or more ICVHMs (P for interaction = .0001).

Conclusions: Age at menarche was inversely associated with the risk of diabetes in adulthood in Chinese women, and it appeared to be modified by the presence of ICVHMs. Further studies are needed to clarify the precise interrelationship and the generalizability of our results.

背景: 既往研究提示月经初潮年龄与糖尿病风险有关。然而尚不清楚理想的心血管健康指标对月经初潮年龄与成年后糖尿病风险之间关系的影响。方法: 我们纳入全国多中心REACTION研究(中国2型糖尿病患者恶性肿瘤发生风险的流行病学研究)中121431名女性。糖尿病的诊断基于口服葡萄糖耐量试验和糖化血红蛋白测值。使用Logistic回归和乘法项交互作用分析理想的心血管健康指标在月经初潮年龄与糖尿病相关性之间的潜在交互作用。结果: 多变量校正后; 与月经初潮年龄14-17岁者相比; 月经初潮年龄<14岁和> 17岁组的糖尿病风险比值比(95%可信区间)分别为1.22(1.17-1.28)和0.89(0.85-0.93)。分层分析中; 在总胆固醇; 血压水平和月经初潮年龄与糖尿病风险之间存在显著的交互作用(交互作用P 值分别为 0.0091和0.0019)。在有≤3个理想的心血管健康指标的女性中观察到月经初潮年龄<14岁与成年后糖尿病发生风险增加显著相关; 但在有4个或更多理想的心血管健康指标的女性中则没有观察到显著的风险增加(理想的心血管健康指标的数量与月经初潮年龄之间的交互作用P值 = 0.0001)。结论: 女性成年后患糖尿病的风险与月经初潮年龄呈负相关; 而这种关系或可因理想的心血管健康指标而改变。需进一步研究以阐明其中的相互关系以及研究结果的普遍性。.

Keywords: age at menarche; cardiovascular health metrics; diabetes; lifestyle; 心血管健康指标; 月经初潮年龄; 生活方式; 糖尿病.

Publication types

Multicenter Study

MeSH terms

Adolescent
Adult
Age Factors
Aged
Cardiovascular Diseases / diagnosis
Cardiovascular Diseases / epidemiology*
Cardiovascular Diseases / prevention & control
China / epidemiology
Diabetes Mellitus, Type 2 / diagnosis
Diabetes Mellitus, Type 2 / epidemiology*
Diabetes Mellitus, Type 2 / prevention & control
Female
Health Status*
Healthy Lifestyle
Humans
Menarche*
Middle Aged
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Risk Reduction Behavior
Sex Factors
Time Factors

Abstract in English, Chinese

Publication types

MeSH terms

Grants and funding

Abstract
in English, Chinese