Early age at menarche and metabolic cardiovascular risk factors: mediation by body composition in adulthood

Area of Science:

• Reproductive Health
• Cardiovascular Epidemiology
• Metabolic Health

Background:

• Early menarche (before age 12) is increasingly recognized as a potential risk factor for cardiometabolic diseases.
• Adiposity has been hypothesized as a mediator linking early menarche to adverse cardiovascular outcomes.
• Understanding these associations is crucial for developing targeted preventive strategies.

Purpose of the Study:

• To assess the association between age at menarche and cardiovascular risk factors in adulthood.
• To quantify the indirect effect of adult body composition on this association.
• To investigate potential mediation pathways in a prospective cohort.

Main Methods:

• Prospective cohort study of women born in Pelotas, Brazil, in 1982.
• Data collected at age 30 years, including age at menarche and metabolic cardiovascular risk factors.
• Mediation analysis using G-computation to estimate direct and indirect effects.

Main Results:

• Women with menarche before age 12 (24.5%) had higher diastolic blood pressure, total cholesterol, LDL-cholesterol, and triglycerides.
• Body composition, specifically fat mass index, mediated 43.8% to 98.9% of the effect of early menarche on these risk factors.
• No significant mediation was observed for systolic blood pressure, HDL-cholesterol, or C-reactive protein.

Conclusions:

• Early menarche is associated with unfavorable metabolic cardiovascular risk profiles in adulthood.
• Adult body composition plays a partial mediating role in the relationship between early menarche and certain cardiometabolic risk factors.
• These findings highlight the importance of monitoring body composition in women with early menarche.