[Effect of menopausal status on onset of impaired fasting glucose and type 2 diabetes mellitus].

Objective: To investigate the relationship between menopausal status at different FPG levels and the risk of new onset of impaired fasting glucose (IFG) and type 2 diabetes mellitus (T2DM). Methods: Female subjects were selected from the females who joined in the epidemiological survey between May and September in 2009 in six counties of Guanlin Village and Xushe Village in Yixing City in Jiangsu Province by cluster sampling method. Subjects with diabetes at baseline or pre-menopause with age above 65 years old or surgical menopause were excluded. Finally there were 2 084 eligible subjects included in this study. According to FPG at baseline, subjects were categorized into two groups as normal FPG group (FPG<5.6 mmol/L) and IFG group (5.6≤FPG≤6.9 mmol/L). Follow-up study was conducted from May in 2014 to January in 2016. Cox regression model was used to investigate the association between menopausal factors and IFG and T2DM among groups based on FPG. Results: The average age of subjects at baseline was 58.08 (51.74-65.82) years old, and the number of post-menopausal women was 1 631 (78.3%). The number of subjects in normal FPG group was 1 569 (75.3%), and in IFG group was 515 (24.7%). There were 104 subjects with new onset T2DM among which 34 subjects from normal FPG group and 70 subjects from IFG group. And there were 199 subjects with new onset IFG in normal FPG group. Among subjects with normal FPG, the incidence density of IFG in post-menopausal women (2 752/100 000 person-years) was statistically higher than that in premenopausal women (1 670/100 000 person-years) (P<0.001). After age and BMI adjusted, post-menopausal women had a higher risk of having IFG in normal FPG subjects with hazard ratio (HR) at 2.60 (P<0.001). Among subjects with normal FPG, the risk of new onset IFG decreased in post-menopausal women with menopause age increasing after age and BMI adjusted, with HR at 0.96 (P=0.046). No statistical association was found between menopausal factors and risk of T2DM either in the overall subjects or in the subgroups(P>0.05). Conclusion: Menopause can increase the risk of IFG incidence in subjects with normal FPG. The incidence of IFG decreases with the menopause age increasing.目的： 探讨女性不同FPG水平下绝经状态对新发空腹血糖受损（IFG）及2型糖尿病（T2DM）风险之间的关系。 方法： 采用整群抽样方法，选取江苏省宜兴市官林镇和徐舍镇两个乡镇的6个村的参与过2009年5—10月开展的流行病学调查的女性，排除基线有糖尿病、65岁以上未绝经及手术绝经者，最终共有2 084名女性纳入研究。根据FPG水平将基线纳入研究的对象分为FPG正常组（FPG<5.6 mmol/L）和IFG组（5.6~6.9 mmol/L），并于2014年5月至2016年1月对上述对象进行前瞻性随访。采用Cox回归模型探讨不同FPG水平对象绝经相关因素与IFG和T2DM之间的关系。 结果： 研究对象年龄[P(50)（P(25)~P(75)）]为58.08（51.74~65.82）岁，其中已绝经女性1 631名（78.3%），T2DM发病104例。FPG正常组1 569名（75.3%），T2DM发病34例，IFG发病199例；IFG组515名（24.7%），T2DM发病70例。FPG正常组中，已绝经者IFG发病密度（2 752/10万人年）高于未绝经者（1 670/10万人年）（P<0.001）；调整年龄和BMI后，FPG正常组已绝经者发生IFG风险增高（HR=2.60，P<0.001）。FPG正常组中，调整年龄和BMI后，已绝经女性随着绝经年龄的增加，发生IFG的风险降低（HR=0.96，P=0.046）。在总人群、FPG正常组以及IFG组中，未发现绝经状态和绝经年龄与T2DM发病风险之间存在关联（P值均>0.05）。 结论： FPG正常人群中，绝经增加IFG事件的发生风险。随着绝经年龄的增加，FPG正常人群IFG事件发生风险降低。.