Objective  To analyze the correlation between early or late age at natural menopause and obesity among postmenopausal women, and to provide reference for health care of postmenopausal women.

  Methods  From November 2017 through January 2020, totally 5 646 natural menopausal women aged ≥ 50 years were recruited from the voluntary participants of a prospective cohort study on chronic diseases in middle-aged and elderly residents of Guangzhou city. The women's information on demographic characteristics and physical indicators (including body mass index BMI, waist circumference WC, and waist-hip ratio WHR) were collected from the baseline survey of the cohort study. Generalized linear model, multivariate logistic regression model and restricted cubic spline analysis model were adopted in data analysis using SPSS 25.0 and STATA 16.0.

  Results  For all the women aged 60.0 ± 5.8 years, the mean age at menopause was 50.3 ± 3.1 years and the age at natural menopause was u-shaped associated with obesity. After adjusting for possible confounders, the results of multivariate logistic regression analysis showed that compared with the women with a normal age at natural menopause (46 – 53 years), the women with an early age at natural menopause (< 46) were more likely to have an increased risk of central obesity determined by WC (odds ratio OR = 1.32, 95% confidence interval 95% CI: 1.03 – 1.69) or WHR (OR = 1.32, 95% CI: 1.06 – 1.64) and overweight/obesity determined by BMI (OR = 1.39, 95% CI: 1.13 – 1.71); while, the women with a late age at natural menopause (> 53) were also more likely to have an increased the risk of central obesity determined by WC ( OR = 1.34, 95% CI: 1.11 – 1.63) or WHR (OR = 1.41, 95% CI: 1.19 – 1.68) and overweight/obesity determined by BMI (OR = 1.49, 95% CI: 1.26 – 1.76).

  Conclusion  Early or late age at natural menopause are associated with an increased risk of postmenopausal obesity for middle-aged and elderly women. The results suggest that the women with early or late age at natural menopause should pay more attention to muscle training and balanced diet and appropriately control the intake of food mainly providing energy.