Age at menopause and risk of sarcopenia in postmenopausal women: evidence from the China health and retirement longitudinal study

BACKGROUND: Menopausal age is closely associated with women's health, but research on its association with sarcopenia risk remains insufficient. Our study aimed to explore how menopausal age affects the risk of sarcopenia in postmenopausal women. METHODS: Based on the China Health and Retirement Longitudinal Study (CHARLS) database, we included 3,410 postmenopausal women from 2011-2015. Participants were divided into five groups according to menopausal age: premature menopause (< 40 years), early menopause (40-44 years), intermediate menopause (45-49 years), normal menopause (50-55 years), and late menopause (> 55 years). Sarcopenia was identified using the 2019 Asian Working Group for Sarcopenia (AWGS 2019) criteria. Mixed-effects logistic regression models were used to analyze the association between menopausal age and sarcopenia. RESULTS: The study included 3,410 postmenopausal women with a mean age of 64.39 ± 8.68 years and overall sarcopenia prevalence of 35.40%. Compared to the average age at menopause group (50-55 years; 1,593/3,410; 46.70%), premature menopause (127/3,410; 3.70%), early menopause (385/3,410; 11.30%), intermediate menopause (1,098/3,410; 32.20%), and late menopause (207/3,410; 6.10%) were all associated with increased sarcopenia risk. Compared to normal menopause (50-55 years), early menopause (40-44 years), intermediate menopause (45-49 years), and late menopause (> 55 years) were associated with statistically significant increased sarcopenia risk, while premature menopause (< 40 years) showed a non-significant elevated risk (OR = 1.40, 95% CI: 0.89-2.21, p = 0.1438). This association was stronger among women with late menarche, rural residence, married status, non-retirement, or low education levels. CONCLUSIONS: Both earlier and later than average menopausal age may be associated with increased sarcopenia risk in Chinese postmenopausal women, although the association for premature menopause did not reach statistical significance in fully adjusted models.