Mediation effect of body mass index on the association between age at menopause and type 2 diabetes mellitus in postmenopausal Chinese women
Mediation effect of body mass index on the association between age at menopause and type 2 diabetes mellitus in postmenopausal Chinese women
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DOI：
10.1097/gme.0000000000001946
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发表时间：
2022-01
期刊：
影响因子：
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通讯作者：
Yijing Zhao;Suli Wang;Y. Yang;Wen Cao;Kun Chen;Kun Wang
中科院分区：
文献类型：
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作者：
Yijing Zhao;Suli Wang;Y. Yang;Wen Cao;Kun Chen;Kun Wang
摘要目的：本研究旨在探讨绝经年龄与2型糖尿病（T2 DM）之间的关系，以及这种关系是否由中国绝经后妇女的体重指数（BMI）介导。方法：这项横断面研究纳入了4，279名绝经后妇女。采用二元logistic回归分析来估计绝经年龄与T2 DM之间的相关性。采用多元线性回归模型分析绝经年龄与空腹血糖（FPG）、餐后2小时血糖（2 hPBG）、胰岛素抵抗稳态模型评估（HOMA）-IR和胰岛细胞功能稳态模型评估（HOMA-IR）的关系。中介分析，以调查这些协会是否介导的BMI。结果如下：完全校正后，绝经年龄较晚的女性（>54岁）比参考组（4453岁）更容易患T2 DM（比值比=1.401，95%置信区间[CI]，1.010-1.945; P = 0.044）。经过多次校正后，绝经年龄每增加1岁，FPG增加0.021 mmol/L（95%CI，0.004-0.038; P = 0.014），PBG 2小时增加0.048 mmol/L（95% CI，0.0060.090; P = 0.024），HOMA-β降低1.540（95% CI，-2.386 ~-0.695;绝经年龄晚与超重/肥胖相关（比值比= 1.416，95% CI，1.028-1.950; P = 0.015）。BMI在绝经年龄与FPG、2 hPBG的关系中起部分中介作用，其作用比例分别为5.42%和7.69%。此外，BMI抑制了绝经年龄与HOMA-β之间的关联，抑制效果的比例为9.54%。结论：绝经年龄晚与2型糖尿病的发生呈正相关。BMI部分介导了绝经年龄与血糖状态之间的关联，并抑制了绝经年龄与HOMA-β之间的关联。有必要进行前瞻性研究来证实这种关联。
Abstract Objective: This study aimed to examine the association between age at menopause and type 2 diabetes mellitus (T2DM), and whether this association is mediated by body mass index (BMI) in postmenopausal Chinese women. Methods: This cross-sectional study enrolled 4,279 postmenopausal women. Binary logistic regression was used to estimate the association between age at menopause and T2DM. A multiple linear regression model was used to evaluate the relationships between age at menopause and fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPBG), homeostasis model assessment for insulin resistance (HOMA)-IR, and HOMA of ß-cell function (HOMA-ß). Mediation analysis was performed to investigate whether these associations were mediated by BMI. Results: After full adjustment, women with a later age of menopause (>54 y) were more likely to have T2DM (odds ratio =1.401, 95% confidence interval [CI], 1.010-1.945; P = 0.044) than those in the reference group (4453 y). After multiple adjustments, each 1-year increase in the age at onset of menopause was associated with a 0.021 mmol/L increase in FPG (95% CI, 0.004-0.038; P = 0.014), 0.048 mmol/L increase in2hPBG (95% CI, 0.0060.090; P = 0.024), and 1.540 decrease in HOMA-ß (95% CI, —2.386 to —0.695; P < 0.001), but no changes in HOMA-IR. Later age of menopause was associated with overweight/general obesity (odds ratio = 1.416, 95% CI, 1.028-1.950; P = 0.015). BMI partially mediated the association between age at menopause and FPG and 2hPBG, and the proportion of the effect was 5.42% and 7.69%, respectively. Further, BMI suppressed the association between age at menopause and HOMA-ß, and the proportion of the suppressing effect was 9.54%. Conclusions: The later age of menopause was positively related to T2DM. BMI partially mediated the association between age at menopause and glucose status and suppressed the association between age at menopause and HOMA-ß. Prospective studies are warranted to confirm this association.