目的 通过研究月经初潮年龄影响下的青年女性动态血压监测(ABPM)参数的差异,总结初潮年龄与血压之间的关系.方法 2022年1月至2023年10月间纳入兰州市青年(18～30岁)女性180人,平均月经初潮年龄为13.49岁.依据平均月经初潮年龄分为初潮较早(＜14岁)组88人与较晚(≥14岁)组92人.对所有受试者进行24 h ABPM,对比分析两组之间动态血压相关参数的差异.采用Pearson相关性分析和多元线性回归分析方法分析初潮年龄与动态血压参数的相关性.结果 与初潮年龄≥14岁的女性相比,初潮年龄＜14岁的女性体重指数[(22.54±3.51)比(20.79±3.32)kg/m2,t=3.436,P＜0.001]、24 h 平均收缩压[(121.50±16.15)比(116.37±14.52)mmHg,t=2.223,P=0.026]、白天平均收缩压[(123.89±16.05)比(118.21±14.54)mmHg,t=2.466,P=0.014]、白大衣窗口(前 4 次 ABPM 测量数据)平均收缩压[(131.58±23.31)比(120.67±18.78)mmHg,t=3.100,P=0.002]、24 h收缩压负荷、白天收缩压负荷均较高.Pearson相关性分析显示,初潮年龄与体重指数(r=-0.302,P＜0.001)、24 h 平均收缩压(r=-0.259,P＜0.001)、白天平均收缩压(r=-0.275,P＜0.001)、夜间平均收缩压(r=-0.211,P=0.004)、白大衣窗口平均收缩压(r=-0.249,P=0.001)、清晨平均收缩压(r=-0.179,P=0.016)呈负相关.多元线性回归分析显示,在校正体重指数、年龄、腹围后,初潮年龄与24 h平均收缩压仍独立相关(B=-1.918,P=0.025).结论 与月经初潮较晚(≥14岁)的年轻女性相比,初潮较早(＜14岁)者的体重指数、收缩压和收缩压负荷较高;初潮年龄越小,动态收缩压越高;初潮年龄提前是24 h平均收缩压升高的独立危险因素.
Correlation between age of menarche and ambulatory blood pressure parameters in young women
Objective To summarize the relationship between menarche age and blood pressure by investigating the differences in ambulatory blood pressure monitoring(ABPM)parameters among young women of different menarche ages.Methods A total of 180 young women(18 to 30 years old)in Lanzhou City were included from January 2022 to October 2023.The average age of menarche was 13.49 years old.According to the average age of menar-che,the women were divided into early menarche group(＜14 years old,n=88)and later menarche group(≥ 14 years old,n=92).Twenty-four-hour ABPM was performed on all subjects,and the differences of ABPM parame-ters between the two groups were compared and analyzed.Pearson correlation analysis and multiple linear regression analysis were used to analyze the correlation between age of menarche and ABPM parameters.Results Compared with the later menarche group,women in the early menarche group had higher body mass index(BMI)[(22.54±3.51)vs(20.79±3.32)kg/m2,t=3.436,P＜0.001],mean 24-hour systolic blood pressure[(121.50±16.15)vs(116.37±14.52)mmHg,t=2.223,P=0.026],mean daytime systolic blood pressure[(123.89±16.05)vs(118.21±14.54)mmHg,t=2.466,P=0.014],mean systolic blood pressure of the white coat window(first 4 ABPM measurements)[(131.58±23.31)vs(120.67±18.78)mmHg,t=3.100,P=0.002],24-hour systolic blood pressure load and daytime systolic blood pressure load.Pearson correlation analysis showed that age at menar-che was associated with BMI(r=-0.302,P＜0.001),mean 24-hour systolic blood pressure(r=-0.259,P＜0.001),mean daytime systolic blood pressure(r=-0.275,P＜0.001),mean nighttime systolic blood pressure(r=-0.211,P=0.004),mean systolic blood pressure at the white coat window(r=-0.249,P=0.001),and mean systolic blood pressure in the morning(r=-0.179,P=0.016).Multiple linear regression analysis showed that after adjusting for BMI,age and abdominal circumference,age at menarche was still independently correlated with 24-hour systolic blood pressure(B=-1.918,P=0.025).Conclusions BMI,systolic blood pressure and systolic blood pressure load are higher in women with early menarche(＜14 years)than in women with late menar-che(≥14 years).The smaller the age of menarche,the higher the systolic blood pressure.Early menarche age is an independent risk factor for increased 24-hour systolic blood pressure.
menarcheambulatory blood pressure monitoringbody mass indexblood pressure loadcirca-dian rhythm
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