Age at Menarche and Type 2 Diabetes Risk

Abstract

OBJECTIVEYounger age at menarche, a marker of pubertal timing in girls, is associated with higher risk of later type 2 diabetes. We aimed to confirm this association and to examine whether it is explained by adiposity.RESEARCH DESIGN AND METHODSThe prospective European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from 26 research centers across eight European countries. We tested the association between age at menarche and incident type 2 diabetes using Prentice-weighted Cox regression in 15,168 women (n = 5,995 cases). Models were adjusted in a sequential manner for potential confounding and mediating factors, including adult BMI.RESULTSMean menarcheal age ranged from 12.6 to 13.6 years across InterAct countries. Each year later menarche was associated with 0.32 kg/m2 lower adult BMI. Women in the earliest menarche quintile (8–11 years, n = 2,418) had 70% higher incidence of type 2 diabetes compared with those in the middle quintile (13 years, n = 3,634), adjusting for age at recruitment, research center, and a range of lifestyle and reproductive factors (hazard ratio [HR], 1.70; 95% CI, 1.49–1.94; P < 0.001). Adjustment for BMI partially attenuated this association (HR, 1.42; 95% CI, 1.18–1.71; P < 0.001). Later menarche beyond the median age was not protective against type 2 diabetes.CONCLUSIONSWomen with history of early menarche have higher risk of type 2 diabetes in adulthood. Less than half of this association appears to be mediated by higher adult BMI, suggesting that early pubertal development also may directly increase type 2 diabetes risk.

Impact of age at menarche on obesity and glycemic control in Japanese patients with type 2 diabetes: Fukuoka Diabetes Registry

“…To the best of the authors’ knowledge, this is the first study to report on the association between age at menarche in patients with type 2 diabetes. It is reported that earlier‐onset menarche is associated with obesity and the development of type 2 diabetes mellitus in later life2, 3, 4, 5, 6, 7, 8, 9, 10, 11. The present results extend the association between age at menarche and obesity to patients with type 2 diabetes.…”

“…Earlier age at menarche is associated with the future development of type 2 diabetes in Western and Asian populations4, 6, 7, 8, 9, 10, 11, and was associated with elevated HbA 1c , secondary to high BMI in the current study. These associations can be largely explained by increased adiposity.…”

“…They are presented with 95% confidence intervals (95% CI) that were back‐transformed. Participants were divided into five categories according to age at menarche: ≤11, 12, 13, 14 and ≥15 years, as reported in previous studies4, 6, 7, 9. Baseline characteristics by categories of age at menarche were explored using one‐way analysis of variance and analysis of covariance to compare means of continuous variables, and using χ 2 ‐tests to compare proportions of categorical variables.…”

“…In Japan, the mean age at menarche decreased from 13.2 years in 1961 to 12.2 years in 2011 in school‐aged girls1. Earlier‐onset menarche is reported to be associated with obesity2, 3, 4, 5, type 2 diabetes mellitus4, 6, 7, 8, 9, 10, 11, cardiovascular disease4, 12, 13, 14, breast cancer15 and increased all‐cause mortality4, 13, 16, 17, 18. It is therefore possible that age at menarche can provide important information to help prevent non‐communicable diseases.…”

Specific features of cellular aging in women in different periods of life

“…Эти результаты согласуются с данными иссле-дований британской когорты женщин EPIC-InterAct (European Prospective Investigation into Cancer and Nutrition) и ARIC (Atherosclerosis Risk in Communities) [10,13,15]. Ана-логичную взаимосвязь выявили и в двух азиатских иссле-дованиях [16,17], в то время как в параллельном исследо-вании у китайских женщин эта связь не определена [18].…”