Association between age at menarche and risk of diabetes in adults: results from the EPIC-Norfolk cohort study

Abstract

Aims/hypothesis Earlier age at menarche is associated with increased BMI and obesity risk from early childhood through to adulthood. We hypothesised that earlier age at menarche would also predict subsequent diabetes risk. Methods This was a population-based prospective cohort study of 13,308 women, who were aged 40 to 75 years between 1993 and 1997 and participating in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk). We used data on age at menarche and ascertained diabetes incidence to 2005. Results There were 734 cases of diabetes (363 incident and 371 prevalent cases). Mean age at menarche was lower in women with diabetes than in non-diabetic women (12.8 vs 13.0 years, p=0.008). Compared with the earliest quintile (menarche at 8-11 years), women in the oldest quintile (menarche at 15-18 years) had lower BMI (25.5 vs 27.4 kg/m 2 , p<0.0001) and a reduced risk of diabetes (OR 0.66 [95% CI 0.51-0.86] adjusted for age, family history, physical activity, smoking, occupational social class, parity and use of hormonal preparations). The association between age at menarche and diabetes was linear (adjusted OR 0.91 [95% CI 0.87-0.96] per 1 year later menarche) and appeared to be completely mediated by adult BMI or waist circumference , further adjusted for BMI at age 40-75 years). Conclusions/interpretation Earlier age at menarche increases the risk of diabetes in women and this association appears to be mediated by increased adiposity. History of earlier menarche may help to identify women with increased subsequent risk of diabetes.

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.…”

Ovarian function and obesity—Interrelationship, impact on women's reproductive lifespan and treatment options

“…showing that earlier age of menarche onset increases the risk of adult diabetes and this appears to be M a n u s c r i p t mediated by greater adult adiposity (Lakshman et al, 2008). These data support the advice that healthy lifestyle with adequate caloric intake and physical activity should be strongly advocated in childhood.…”