The relationship of menstrual irregularity to type 2 diabetes in Pima Indian women
The relationship of menstrual irregularity to type 2 diabetes in Pima Indian women
复制标题
DOI：
10.2337/diacare.21.3.346
复制
发表时间：
1998-03-01
期刊：
影响因子：
16.2
通讯作者：
Knowler, WC
中科院分区：
文献类型：
--
作者：
Roumain, J;Charles, MA;Knowler, WC
目的-月经不调与非糖尿病皮马印第安育龄妇女的高胰岛素血症和高雄激素血症有关。在这项基于人群的研究中，我们确定了皮马印第安妇女月经不调与 2 型糖尿病的关系。 研究设计和方法 - 这项横断面分析的参与者是 695 名年龄 18-44 岁的非怀孕皮马印第安妇女，参与了一项正在进行的亚利桑那州吉拉河印第安社区居民糖尿病流行病学研究。通过问卷调查和检查（包括 75 克口服葡萄糖耐量试验）收集临床数据；糖尿病是按照世界卫生组织的标准诊断的。月经不规律的定义是，自 18 岁起，未怀孕时，月经之间的间隔为 3 个月或以上。 结果：在最不肥胖的女性 (BMI < 30 kg/m(2)) 中，经期不规律史与糖尿病的高患病率显着相关 (37 vs 13%；比值比 = 4.2，95% CI = 1.6-10.8)，并根据年龄和整体肥胖的影响进行调整。这种关联的部分原因是月经不调的女性中心性肥胖程度更高。在较肥胖的女性中，与月经不规律几乎没有关系，而且无论月经史如何，糖尿病都很常见。结论——有月经不规律史的皮马印第安女性中 2 型糖尿病的患病率较高。这种差异在最不肥胖的女性群体中最为明显。这种关联可能是因为胰岛素抵抗和高胰岛素血症，这预示着 2 型糖尿病，也会导致雄激素过多症和月经不调。这些发现强调了评估月经不规律女性高血糖的必要性。
OBJECTIVE- Menstrual irregularity is associated with hyperinsulinemia and hyperandrogenemia in nondiabetic Pima Indian women of child-bearing age. In this population-based study, we determined the relationship of menstrual irregularity to type 2 diabetes in Pima Indian women.RESEARCH DESIGN AND METHODS- Participants for this cross-sectional analysis were 695 nonpregnant Pima Indian women, aged 18-44 years, involved in an ongoing epidemiologic study of diabetes among residents of the Gila River Indian Community of Arizona. Clinical data were collected by questionnaire and an examination that included a 75-g oral glucose tolerance test; diabetes was diagnosed by World Health Organization criteria. Menstrual irregularity was defined as an interval of 3 months or more between menses, when not pregnant, since age 18 years.RESULTS- History of menstrual irregularity was significantly associated with a high prevalence of diabetes (37 vs, 13%; odds ratio = 4.2, 95% CI = 1.6-10.8) in the least obese women (BMI < 30 kg/m(2)), adjusted for the effects of age and overall obesity. This association was, in part, because of greater central obesity in women with irregular menses. In more obese women, there was little association with menstrual irregularity, and diabetes was frequent regardless of menstrual history.CONCLUSIONS- Prevalence of type 2 diabetes is higher among Pima Indian women with a history of menstrual irregularity. The difference is most pronounced among the least obese group of women. This association may be because of insulin resistance and hyperinsulinemia, which predict type 2 diabetes, also causing hyperandrogenism and menstrual irregularity. The findings reinforce the need to evaluate women with menstrual irregularity for hyperglycemia.