深圳市育龄女性体重指数与月经周期异常的相关性研究

Association of body mass index with abnormal menstrual cycle among reproductive-age females in Shenzhen

目的探讨育龄女性体重指数(BMI)与月经周期异常的关系。方法以2013~2018年参加深圳市孕前优生健康检查的231 449例育龄女性为研究对象,通过问卷调查、体格检查、临床检验等方法收集相关信息,使用非条件Logistic回归模型和限制性立方样条分析BMI与月经周期异常的关联及其剂量-反应关系。结果月经周期异常的育龄女性占16.36%;体重过低、超重、肥胖者分别占20.28%、9.74%、1.91%。多因素分析结果显示,与体重正常组育龄女性相比,超重组和肥胖组育龄女性月经周期异常的风险分别高出36%[OR=1.36,95%CI(1.31,1.41)]和78%[OR=1.78,95%CI(1.66,1.91)],体重过低组育龄女性月经周期异常的风险降低7%[OR=0.93,95%CI(0.91,0.96)]。限制性立方样条分析结果显示,BMI与月经周期异常的关联强度呈非线性剂量-反应关系(非线性检验,P<0.000 1),即BMI在17.50~20.50 kg/m^2时,月经周期异常的风险较低;当BMI<17.50 kg/m^2或BMI>20.50 kg/m^2,月经周期异常风险增加(以BMI 20.29 kg/m^2为参比值)。结论育龄女性BMI与月经周期异常相关,将体重控制在适当范围,可降低月经周期异常的发生风险,对提高育龄女性生殖健康水平具有重要意义。

Objective:To investigate the association between body mass index(BMI)and abnormal menstrual cycle among reproductive-age females.Methods:A total of 231449 reproductive-age females who participated in Shenzhen Free Preconception Checkup Projects from 2013 to 2018 were enrolled as the study objects.Relevant information was collected by questionnaire surveys,physical examination and clinical examination.The association between BMI and abnormal menstrual cycle and its dose-response relationship were analyzed using the non-conditional logistic regression model and restricted cubic spline model.Results:Reproductive-age females with abnormal menstrual cycle accounted for 16.36%,and those with underweight,overweight and obese accounted for 20.28%,9.74%and 1.91%,respectively.The results of multivariate analysis showed that the risk of abnormal menstrual cycle were 36%[OR=1.36,95%CI(1.31,1.41)]and 78%[OR=1.78,95%CI(1.66,1.91)]higher in the overweight and obese groups compared with the normal weight group,while the risk of abnormal menstrual cycle was 7%[OR=0.93,95%CI(0.91,0.96)]lower in the underweight group.The restricted cubic spline analysis results showed that the association between BMI and abnormal menstrual cycle was nonlinear dose-response relationship(non-linearity test,P<0.0001).Namely,the BMI=17.50-20.50 kg/m2,the risk of abnormal menstrual cycle was lower,when the BMI<17.50 kg/m2 or BMI>20.50 kg/m2,the risk of abnormal menstrual cycle increased(BMI 20.29 kg/m2 as the reference value).Conclusions:BMI is correlated to abnormal menstrual cycle in reproductive-age females.Controlling weight in an appropriate range can reduce the risk of abnormal menstrual cycle,which is of great significance for improving reproductive health of reproductive-age females.