Age at menarche and type 2 diabetes risk: the EPIC-InterAct study
Cathy E Elks1, Ken K Ong, Robert A Scott
1Corresponding author: Cathy E. Elks, cathy.elks@mrc-epid.cam.ac.uk.
Diabetes Care
|October 26, 2013
Summary
Younger age at menarche increases type 2 diabetes risk in women. This link is only partially explained by adult body mass index (BMI), suggesting early puberty may directly impact diabetes risk.
Area of Science:
- Endocrinology
- Epidemiology
- Public Health
Background:
- Early menarche is linked to increased risk of type 2 diabetes.
- The role of adiposity in this association requires further investigation.
Purpose of the Study:
- To confirm the association between age at menarche and type 2 diabetes risk.
- To determine if adiposity mediates this relationship.
Main Methods:
- Prospective case-cohort study (EPIC-InterAct) involving 12,403 type 2 diabetes cases and 16,154 individuals.
- Prentice-weighted Cox regression analysis was used to assess the association between age at menarche and incident type 2 diabetes in 15,168 women.
- Models were sequentially adjusted for confounding and mediating factors, including adult BMI.
Main Results:
- Each year of later menarche was associated with a 0.32 kg/m2 decrease in adult BMI.
- Women with the earliest menarche (8-11 years) had a 70% higher incidence of type 2 diabetes compared to those with menarche at 13 years (HR, 1.70).
- Adjusting for BMI partially attenuated the association (HR, 1.42), indicating BMI explains less than half of the observed risk.
Conclusions:
- Early menarche is associated with a significantly higher risk of adult type 2 diabetes.
- Higher adult BMI mediates less than half of this association.
- Early pubertal development may directly contribute to increased type 2 diabetes risk independently of BMI.
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