Early menarche is associated with insulin resistance in advanced maternal age before delivery

Abstract

Purpose: With the wide implementation of the universal two-child policy in China, the number of pregnant women in advanced maternal age (AMA) will increase gradually. We aimed to assess the association between age at menarche (AAM) and insulin resistance (IR) before delivery in AMA. Methods: A total of 80 pregnant women in AMA were consecutively enrolled before delivery in Zhongda hospital. Pregnant women were stratified into early menarche group and late menarche group according to the age of regular menstruation (about 13 years). At delivery, serum glucose and lipid levels were measured. IR was calculated by the method of homeostasis model assessment 2(HOMA2). Results: The fasting blood insulin (17.68(9.72–36.71) and 10.35(7.76–15.10), respectively; p = .006) and HOMA-IR (2.08(1.18–4.37) and 1.24(0.89–1.78), respectively; p = .005) were higher in early menarche group than in late menarche group. AAM was inversely associated with HOMA-IR in AMA (r= −0.27, p = .014). In the multivariable analysis, AAM in late menarche group was negatively related to the level of HOMA-IR compared to those in early menarche group (β= −2.275, p≤.0001). Conclusions: Taken together, our findings suggest that AAM was inversely associated with HOMA-IR in AMA. Furthermore, pregnant women in AMA with early menarche might have higher HOMA-IR levels than those with late menarche.

Clinical trial registration: Chinese Clinical Trial Registry (No. ChiCTR-RRC-16008714), retrospectively registered

摘要

目的：随着二胎政策在中国的全面广泛实施, 高龄孕妇的数量会逐渐增多。我们旨在评估在高龄孕妇分娩前初潮年龄（AAM）与胰岛素抵抗（IR）之间的关系。方法：连续纳入共80名中大医院的分娩前高龄孕妇。根据建立规律月经周期的年龄（大概13岁）将孕妇分为早初潮组和晚初潮组。分娩时测定血糖和血脂水平。采用稳态模型评估法2(HOMA2)计算IR。结果：早初潮组的空腹血胰岛素(分别为：17.68(9.72–36.71)和10.35(7.76–15.10); p＝.006)和HOMA-IR (分别为：2.08(1.18–4.37)和1.24(0.89–1.78); p＝.005)高于晚初潮组。在高龄孕妇中, AAM与HOMA-IR之间呈负相关(r＝－0.27, p＝.014)。在多因素分析中, 与早初潮组相比, 晚初潮组的AAM与HOMA-IR水平之间呈负相关(β＝－2.275, p≤.0001)。结论：综合起来, 我们的研究结果提示在高龄孕妇中AAM与HOMA-IR之间呈负相关。此外, 初潮年龄早的高龄孕妇相比于初潮年龄晚的其HOMA-IR 水平可能更高。

临床试验注册：中国临床试验注册(No. ChiCTR-RRC-16008714), 回顾性注册

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Age at menarche
• early menarche
• insulin resistance
• advanced maternal age

Acknowledgments

We would like to thank all of participants and the staff of the Department of Obstetrics and Gynecology, Zhongda Hospital, Southeast University, for their selfless assistance.

Disclosure statement

The authors declared no conflict of interest.

Additional information

Funding

This study was supported by grant number 81270010 and 81570739 (Ling Li) and 81800571 (Hao Lin) from the National Natural Science Foundation of China.