中国10个地区成年女性初潮年龄与身高和腿长的关联研究

Association between age at menarche and height and leg length in adult women： findings from survey in 10 areas in China

目的 描述中国慢性病前瞻性研究（CKB）项目覆盖的10个地区30-79岁成年女性初潮年龄与身高和腿长的地区及出生年代分布，并分析初潮年龄与身高和腿长的关联性。方法 剔除初潮年龄缺失或初潮年龄在生理范围外（〈9岁或〉18岁）个体后，285 187名女性纳入分析。使用多元线性回归模型分析初潮年龄与身高和腿长的关系，并根据出生年代和城乡进行亚组分析。结果 10个项目地区女性的平均初潮年龄为（15.2±1.7）岁，平均身高和腿长分别为（154.2±6.0）cm和（71.0±3.7）cm。女性身高和腿长呈现出随出生年代逐渐增加的趋势（线性趋势检验均P〈0.001）。而初潮年龄在1940-1949年代出生的个体略有推迟，之后出生的女性则表现为逐渐提前的趋势（线性趋势检验P〈0.001）。在调整了年龄、地区、教育程度和臀围（仅在分析腿长时调整）后，初潮年龄每晚一岁，身高和腿长分别平均增加0.17 cm和0.20 cm（P值均〈0.001）。相比出生年代较早的女性，出生年代越晚的女性中，初潮年龄与身高和腿长的回归系数越大（交互检验P值均〈0.001）。结论 CKB的10个项目地区女性的初潮年龄与身高和腿长均存在正相关关联。

Objective To describe the regional differences and secular trend in age at menarche, height and leg length in adult women aged 30-79 years in 10 areas included in China Kadoorie Biobank study （CKB）, and evaluate the association between age at menarche and height and leg length in adult women in China. Methods A total of 285 187 women, who had data on age at menarche and who had their menarche at the age between 9-18 years, were included in the analysis. Multiple linear regression models were used to assess the association between age at menarche and height and leg length. Subgroup analyses were performed for different birth cohorts and living areas （urban area or rural area）. Results The overall means （standard deviation） of age at menarche, height and leg length were 15.2 （±1.7） years, 154.2 （±6.0） cm and 71.0 （±3.7） cm, respectively. A significant increasing trend was observed in the mean height and leg length in different birth cohorts （trend： all P〈0.001）, while a decreasing trend was observed in the mean age at menarche, except for a slight increase in women born in 1940s （trend： P〈0.001）. Adjusted for age, study area, educational level and hip circumference （only for models for leg length）, the average height and leg length in women increased by 0.17 cm and 0.20 cm, respectively, for each later age at menarche （both P〈0.001）. The positive associations between age at menarche and both height and leg length were stronger in younger birth cohorts （interaction： both P〈0.001）. Conclusion Age at menarche was positively associated with height and leg length in women in 10 areas included in CKB study.