Abstract: Background Diabetes mellitus is a common chronic disease in postmenopausal women. However，little is known about whether early or delayed age at menopause increases the risk of postmenopausal diabetes. Objective To explore the correlation between the early or delayed age of menopause and fasting blood glucose and diabetes in natural postmenopausal women，so as to provide evidence for the prevention and control of diabetes in this population.Methods A cross-sectional study was conducted using baseline survey data from 4 905 postmenopausal women aged 50 and older in the Guangzhou Prospective Cohort Study on Chronic Diseases in Middle-aged and Elderly Adults. Data were collected between November 2017 and January 2020，covering demographic characteristics，socioeconomic status，lifestyle factors，medical history，and reproductive history. Physical examinations were conducted，including measurements of fasting blood glucose and blood lipid levels. The generalized linear regression（GLM） and Logistic regression models（LRM） of SPSS 28.0 were used to analyze the relationship of menopausal age and fasting blood glucose levels and diabetes. Results The mean age of the participants was（60.1±5.8）years old and the mean age of menopause（50.3±3.1） years.Among them，351 women experienced early menopause（ ≤ 45 years），4 157 had normal menopause（46-54 years），and 397 had delayed menopause（≥ 55 years）. Results from GLM showed that a linear association between menopausal age（ ≥ Median，50 years）and fasting blood glucose（β=0.024，95%CI=0.001-0.046，P<0.05）was found，whereas no significant linear relationship was observed in those with menopausal age <50 years（β=0.019，95%CI=-0.002 to 0.040，P>0.05）. Comparing with the normal age of menopause，the delayed menopausal age was associated with a 41.0% higher risk of diabetes mellitus（OR=1.410，95%CI=1.026-1.938，P<0.05）and a 97.1% increased risk of newly diagnosed diabetes mellitus（OR=1.971，95%CI=1.186-3.276，P<0.01）. In contrast，no significant associations were found between early menopause and diabetes risk（OR=0.882，95%CI=0.612-1.273） or newly diagnosed diabetes（OR=0.760，95%CI=0.410-1.407）（all P>0.05）. Conclusion The delayed menopausal age is associated with an increased level of fasting glucose and risk of diabetes among postmenopausal women. However，no significant correlation was found in those with early age of menopause.It is necessary to strengthen diabetes prevention and control for those with delayed menopausal age in advance.

Key words: Diabetes mellitus, Age at menopause, Fasting glucose, Postmenopausal women

摘要： 背景 糖尿病是绝经后女性常见的慢性疾病，但绝经年龄的提前或延迟是否增加绝经后糖尿病风险，相关研究甚少。目的 探讨绝经年龄提前或延迟与自然绝经后女性空腹血糖和糖尿病的相关性，为绝经后女性糖尿病防控提供参考。方法 选取《广州中老年人慢性病前瞻性队列研究》年龄≥50岁的自然绝经后女性4905名，利用基线调查数据开展横断面研究。调查时间为2017年11月—2020年1月。调查内容包括一般人口特征、社会经济状况、生活方式、疾病史和生育史等，并进行体格检查，检测空腹血糖、血脂等。采用SPSS28.0软件的广义线性回归和Logistic回归模型分析绝经年龄与空腹血糖和糖尿病的关系。结果 参与者平均年龄（60.1±5.8）岁，平均绝经年龄（50.3±3.1）岁，绝经年龄提前（≤45岁）351例，绝经年龄正常（46~54岁）4157例，绝经年龄延迟（≥55岁）397例。广义线性回归模型结果显示，绝经年龄≥50岁与空腹血糖间存在线性关系（β=0.024，95%CI=0.001~0.046，P<0.05），绝经年龄<50岁与空腹血糖间无线性关系（β=0.019，95%CI=-0.002~0.040，P>0.05）。相较于绝经年龄正常，绝经年龄延迟患糖尿病风险增加41.0%（OR=1.410，95%CI=1.026~1.938，P<0.05），新发现糖尿病的患病风险增加97.1%（OR=1.971，95%CI=1.186~3.276，P<0.01）；未发现绝经年龄提前与糖尿病（OR=0.882，95%CI=0.612~1.273）和新发现糖尿病（OR=0.760，95%CI=0.410~1.407）患病风险相关（P>0.05）。结论 女性绝经年龄延迟与绝经后空腹血糖水平和糖尿病风险增加相关，暂未发现绝经年龄提前与绝经后空腹血糖水平和糖尿病相关，有必要提前加强绝经年龄延迟者的糖尿病防控。

关键词: 糖尿病, 绝经年龄, 空腹血糖, 绝经后女性