TY - JOUR

T1 - Age at Menarche and Type 2 Diabetes Risk

T2 - The EPIC-InterAct study

AU - Elks, Cathy E

AU - Ong, Ken K

AU - Scott, Robert A

AU - van der Schouw, Yvonne T

AU - Brand, Judith S

AU - Wark, Petra A

AU - Amiano, Pilar

AU - Balkau, Beverley

AU - Barricarte, Aurelio

AU - Boeing, Heiner

AU - Fonseca-Nunes, Ana

AU - Franks, Paul W

AU - Grioni, Sara

AU - Halkjaer, Jytte

AU - Kaaks, Rudolf

AU - Key, Timothy J

AU - Khaw, Kay Tee

AU - Mattiello, Amalia

AU - Nilsson, Carl Martin Peter

AU - Overvad, Kim

AU - Palli, Domenico

AU - Quirós, J Ramón

AU - Rinaldi, Sabina

AU - Rolandsson, Olov

AU - Romieu, Isabelle

AU - Sacerdote, Carlotta

AU - Sánchez, María-José

AU - Spijkerman, Annemieke M W

AU - Tjonneland, Anne

AU - Tormo, Maria-Jose

AU - Tumino, Rosario

AU - van der A, Daphne L

AU - Forouhi, Nita G

AU - Sharp, Stephen J

AU - Langenberg, Claudia

AU - Riboli, Elio

AU - Wareham, Nicholas J

AU - InterAct Consortium

PY - 2013/11

Y1 - 2013/11

N2 - OBJECTIVE Younger 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 METHODS The 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. RESULTS Mean 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. CONCLUSIONS Women 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.

AB - OBJECTIVE Younger 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 METHODS The 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. RESULTS Mean 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. CONCLUSIONS Women 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.

U2 - 10.2337/dc13-0446

DO - 10.2337/dc13-0446

M3 - Journal article

C2 - 24159179

VL - 36

SP - 3526

EP - 3534

JO - Diabetes Care

JF - Diabetes Care

SN - 0149-5992

IS - 11

ER -