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

Zhang Huanxiang; Qiu Hongbin; Zhang Yiying

doi:10.13406/j.cnki.cyxb.003186

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

Clinical research | 更新时间：2025-10-21

- Association between age at menarche and hyperuricemia in middle-aged and elderly women and the mediating effect of body mass index
- Journal of Chongqing Medical University Vol. 48, Issue 3, Pages: 310-315(2023)
- 作者机构：
  
  佳木斯大学公共卫生学院流行病与卫生统计学教研室，佳木斯 157000
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.003186
  CLC： R589.7
- Received：20 October 2022，
  
  Revised：2022-12-27，
  
  Accepted：16 January 2023，
  
  Published：28 March 2023
- 稿件说明：
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张换想,邱洪斌,张艺潆.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[J].重庆医科大学学报,2023,48(3):310-315.

Zhang Huanxiang,Qiu Hongbin,Zhang Yiying.Association between age at menarche and hyperuricemia in middle-aged and elderly women and the mediating effect of body mass index[J].Journal of Chongqing Medical University,2023,48(3):310-315.
张换想,邱洪斌,张艺潆.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[J].重庆医科大学学报,2023,48(3):310-315. DOI： 10.13406/j.cnki.cyxb.003186.

Zhang Huanxiang,Qiu Hongbin,Zhang Yiying.Association between age at menarche and hyperuricemia in middle-aged and elderly women and the mediating effect of body mass index[J].Journal of Chongqing Medical University,2023,48(3):310-315. DOI： 10.13406/j.cnki.cyxb.003186.

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，

）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

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

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

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.

关键词

Keywords

references

Ponticelli C ， Alfredo Podestà M ， Moroni G . Hyperuricemia as a trigger of immune response in hypertension and chronic kidney disease [J ] . Kidney Int ， 2020 ， 98 （ 5 ）： 1149 - 1159 .

Sharaf El Din UAA ， Salem MM ， Abdulazim DO . Uric acid in the pathogenesis of metabolic，renal，and cardiovascular diseases：a review [J ] . J Adv Res ， 2017 ， 8 （ 5 ）： 537 - 548 .

田　璐，郑　涵，李岩志，等 . 女性月经初潮年龄与肥胖关系的研究 [J ] . 中华流行病学杂志， 2021 ， 42 （ 7 ）： 1231 - 1234 .

Tian L ， Zheng H ， Li YZ ， et al . Relationship between age at menarche and obesity in women [J ] . Chin J Epidemiol ， 2021 ， 42 （ 7 ）： 1231 - 1234 .

Zhang L ， Yang L ， Wang CZ ， et al . Mediator or moderator? The role of obesity in the association between age at menarche and blood pressure in middle-aged and elderly Chinese：a population-based cross-sectional study [J ] . BMJ Open ， 2022 ， 12 （ 5 ）： e051486 .

马娜娜，曾奇兵，王　鑫，等 . 贵州省部分世居少数民族绝经女性初潮年龄与糖尿病关系的探究 [J ] . 现代预防医学， 2022 ， 49 （ 1 ）： 47 - 52 .

Ma NN ， Zeng QB ， Wang X ， et al . Study on the relationship between age at menarche and diabetes mellitus in postmenopausal minority women in Guizhou Province [J ] . Mod Prev Med ， 2022 ， 49 （ 1 ）： 47 - 52 .

Yuan Y ， Bu XQ ， Xiao M ， et al . Associations of age at menarche and age at menopause with diabetes among postmenopausal women in Chongqing，China [J ] . J Obstet Gynaecol Res ， 2022 ， 48 （ 7 ）： 1945 - 1954 .

China Health and Retirement Longitudinal Study (CHARLS) [EB/OL ] . [ 2022-12-02 ] . https://charls.charlsdata.com/Public/ashelf/public/uploads/document/2011-charls-wave1/application/blood_user_guide_en_20140429.pdf https://charls.charlsdata.com/Public/ashelf/public/uploads/document/2011-charls-wave1/application/blood_user_guide_en_20140429.pdf .

Levey AS ， Stevens LA ， Schmid CH ， et al . A new equation to estimate glomerular filtration rate [J ] . Ann Intern Med ， 2009 ， 150 （ 9 ）： 604 - 612 .

Kohler U ， Karlson KB ， Holm A . Comparing coefficients of nested nonlinear probability models [J ] . The Stata Journal ， 2011 ， 11 （ 3 ）： 420 - 438 .

Lee JS ， Lee YA ， Shin CH ， et al . Long-term health outcomes of early menarche in women：an umbrella review [J ] . QJM ， 2022 ， 115 （ 12 ）： 837 - 847 .

Zhang LL ， Li YQ ， Wang CJ ， et al . Early menarche is associated with an increased risk of type 2 diabetes in rural Chinese women and is partially mediated by BMI：the Henan Rural Cohort Study [J ] . Menopause ， 2019 ， 26 （ 11 ）： 1265 - 1271 .

Bubach S ， Horta BL ， Gonçalves H ， et al . Early age at menarche and metabolic cardiovascular risk factors：mediation by body composition in adulthood [J ] . Sci Rep ， 2021 ， 11 （ 1 ）： 148 .

Stöckl D ， Döring A ， Thorand B ， et al . Reproductive factors and serum uric acid levels in females from the general population：the KORA F4 study [J ] . PLoS One ， 2012 ， 7 （ 3 ）： e32668 .

He HJ ， Pan L ， Liu F ， et al . The mediation effect of body composition on the association between menopause and hyperuricemia：evidence from China national health survey [J ] . Front Endocrinol（Lausanne）， 2022 ， 13 ： 879384 .

Eun Y ， Kim IY ， Han K ， et al . Association between female reproductive factors and gout：a nationwide population-based cohort study of 1 million postmenopausal women [J ] . Arthritis Res Ther ， 2021 ， 23 （ 1 ）： 304 .

Di Sessa A ， Grandone A ， Marzuillo P ， et al . Early menarche is associated with insulin-resistance and non-alcoholic fatty liver disease in adolescents with obesity [J ] . J Pediatr Endocrinol Metab ， 2021 ， 34 （ 5 ）： 607 - 612 .

Mishra SR ， Chung HF ， Waller M ， et al . Association between reproductive life span and incident nonfatal cardiovascular disease：a pooled analysis of individual patient data from 12 studies [J ] . JAMA Cardiol ， 2020 ， 5 （ 12 ）： 1410 - 1418 .

Bjelland EK ， Hofvind S ， Byberg L ， et al . The relation of age at menarche with age at natural menopause：a population study of 336 788 women in Norway [J ] . Hum Reprod ， 2018 ， 33 （ 6 ）： 1149 - 1157 .

Apter D ， Reinilä M ， Vihko R . Some endocrine characteristics of early menarche，a risk factor for breast cancer，are preserved into adulthood [J ] . Int J Cancer ， 1989 ， 44 （ 5 ）： 783 - 787 .

Mumford SL ， Dasharathy SS ， Pollack AZ ， et al . Serum uric acid in relation to endogenous reproductive hormones during the menstrual cycle：findings from the BioCycle study [J ] . Hum Reprod ， 2013 ， 28 （ 7 ）： 1853 - 1862 .

Sumino H ， Ichikawa S ， Kanda T ， et al . Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia [J ] . Lancet ， 1999 ， 354 （ 9179 ）： 650 .

Hak AE ， Choi HK . Menopause，postmenopausal hormone use and serum uric acid levels in US women：the Third National Health and Nutrition Examination Survey [J ] . Arthritis Res Ther ， 2008 ， 10 （ 5 ）： R116 .

Jung JH ， Song GG ， Lee YH ， et al . Serum uric acid levels and hormone therapy type：a retrospective cohort study of postmenopausal women [J ] . Menopause ， 2018 ， 25 （ 1 ）： 77 - 81 .

Zhang ZP ， Hu XJ ， Yang CQ ， et al . Early age at menarche is associated with insulin resistance：a systemic review and meta-analysis [J ] . Postgrad Med ， 2019 ， 131 （ 2 ）： 144 - 150 .

Perez-Ruiz F ， Aniel-Quiroga MA ， Herrero-Beites AM ， et al . Renal clearance of uric acid is linked to insulin resistance and lower excretion of sodium in gout patients [J ] . Rheumatol Int ， 2015 ， 35 （ 9 ）： 1519 - 1524 .

Li ML ， Lin JL ， Liang S ， et al . The role of age at menarche and age at menopause in Alzheimer’s disease：evidence from a bidirectional Mendelian randomization study [J ] . Aging ， 2021 ， 13 （ 15 ）： 19722 - 19749 .

韦晓淋，华钰洁，陆　艳，等 . 月经初潮年龄对女性成年后近期和远期肥胖的影响 [J ] . 中华流行病学杂志， 2019 ， 40 （ 2 ）： 142 - 146 .

Wei XL ， Hua YJ ， Lu Y ， et al . Impact of menarche age on the near-term and long-term obesity of adult females [J ] . Chin J Epidemiol ， 2019 ， 40 （ 2 ）： 142 - 146 .

Liu DC ， Zhao Y ， Liu Y ， et al . Adiposity and insulin resistance as mediators between age at menarche and type 2 diabetes mellitus [J ] . Menopause ， 2020 ， 27 （ 5 ）： 579 - 585 .

Stöckl D ， Meisinger C ， Peters A ， et al . Age at menarche and its association with the metabolic syndrome and its components：results from the KORA F4 study [J ] . PLoS One ， 2011 ， 6 （ 10 ）： e26076 .

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