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Age at Menarche and Type 2 Diabetes Risk The EPIC-InterAct study

Author:
  • Cathy E. Elks
  • Ken K. Ong
  • Robert A. Scott
  • Yvonne T. van der Schouw
  • Judith S. Brand
  • Petra A. Wark
  • Pilar Amiano
  • Beverley Balkau
  • Aurelio Barricarte
  • Heiner Boeing
  • Ana Fonseca-Nunes
  • Paul Franks
  • Sara Grioni
  • Jytte Halkjaer
  • Rudolf Kaaks
  • Timothy J. Key
  • Kay Tee Khaw
  • Amalia Mattiello
  • Peter Nilsson
  • Kim Overvad
  • Domenico Palli
  • J. Ramon Quiros
  • Sabina Rinaldi
  • Olov Rolandsson
  • Isabelle Romieu
  • Carlotta Sacerdote
  • Maria-Jose Sanchez
  • Annemieke M. W. Spijkerman
  • Anne Tjonneland
  • Maria-Jose Tormo
  • Rosario Tumino
  • L. Van der A. Daphne
  • Nita G. Forouhi
  • Stephen J. Sharp
  • Claudia Langenberg
  • Elio Riboli
  • Nicholas J. Wareham
Publishing year: 2013
Language: English
Pages: 3526-3534
Publication/Series: Diabetes Care
Volume: 36
Issue: 11
Document type: Journal article
Publisher: American Diabetes Association

Abstract english

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/m(2) 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.

Keywords

  • Endocrinology and Diabetes

Other

Published
  • Genetic and Molecular Epidemiology
  • Internal Medicine
  • ISSN: 1935-5548
Paul Franks
E-mail: paul.franks [at] med.lu.se

Principal investigator

Genetic and Molecular Epidemiology

+46 40 39 11 49

60-12-021

33

Lund University Diabetes Centre, CRC, SUS Malmö, Entrance 72, House 91:12. SE-205 02 Malmö. Telephone: +46 40 39 10 00