Adolescent Oligomenorrhea (Age 14-19) Tracks Into the Third Decade of Life (Age 20-28) and Predicts Increased Cardiovascular Risk Factors and Metabolic Syndrome

作者：Glueck Charles J^*; Woo Jessica G; Khoury Philip R; Morrison John A; Daniels Stephen R; Wang Ping

来源：Metabolism-Clinical and Experimental, 2015, 64(4): 539-553.

DOI：10.1016/j.metabol.2015.01.005

• Metabolic syndrome
• Oligomenorrhea
• Polycystic ovary syndrome
• Impaired fasting glucose-type 2 diabetes mellitus

Objective. Assess whether adolescent oligomenorrhea (age 14-19) tracks into young adulthood (age 20-28) and predicts increased cardiometabolic risk factors, metabolic syndrome (MetS), and impaired fasting glucose-type II diabetes mellitus (IFG + T2DM).
Materials and methods. Prospective study of menstrual cyclicity and its metabolic effects in 865 black and white schoolgirls from age 9 to 19, and 605 of these 865 girls from age 20 to 28.
Main findings. Patterns of menstrual delays (oligomenorrhea) during ages 14-19 and ages 20-28 were closely related (p <.0001). Adolescent menses delay (ages 14-19, p <.0001), mean insulin (ages 20-28, p =.0003), and self-identified polycystic ovary syndrome (PCOS, p =.049) predicted ages 20-28 menses delay. Menses delays during ages 14-19 and 20-28, and, their interaction product were correlated with IFG + T2DM and MetS at ages 20-28. Waist circumference (ages 20-28, p <.0001), mean triglyceride (ages 20-28, p =.005), and the number of average menstrual cycles >= 42 days (ages 20-28, p =.04) predicted IFG + T2DM (ages 20-28). MetS (ages 9-19, p <.0001), mean insulin (ages 20-28, p =.0002), the number of 242 day gaps between menstrual periods (ages 20-28, p =.02), and cigarette smoking at age 18-19 (p =.04) were significant explanatory variables for MetS at ages 27-28. As MetS status category changed from age 14-19 to 27-28 from best to worst: (no -> no), (yes -> no), (yes -> yes), (no -> yes), the number of women with >= 2 menses delays during ages 20-28 rose from 3% to 4% to 15% to 17%, p =.0001. MetS status change from age 9-19 to 27-28 was positively associated with mean insulin (age 20-28, p <.0001), cigarette smoking (age 24-25, p =.01) and the number of menses delays during ages 20-28 (p =.04).
Principal conclusions. Menstrual patterns track from adolescence to young adulthood, and oligomenorrhea predicts MetS and IFG + T2DM. Patterns of menses delays in adolescence should be considered as a significant risk factor for future development of young adult IFG + T2DM, MetS, oligomenorrhea, and polycystic ovary syndrome.

• 出版日期2015-4