Association between age at menarche and diabetes in Korean post-menopausal women: results from the Korea National Health and Nutrition Examination Survey (2007-2009)

Abstract

POST-MENOPAUSAL women are highly exposed to multiple health problems and risk of diabetes is higher in postmenopausal women than in their pre-menopausal counterparts [1]. Diabetes decrease healthrelated quality of life because of diabetic complications, and increase burden of disease [2]. Considering the fact that diabetes-caused death rate per 100,000 is 37.5 in women aged 50-69 years and 186.9 in women aged 70-80 years, whereas 2.7 in women aged 15-49 years, prevention and treatment for diabetes are an important health issue for post-menopausal women [3].Age at menarche is defined as the age at the onset of menstruation in adolescents and is frequently used Abstract. Early menarche is known to be associated with diabetes, however this association remains controversial. Our study aimed to investigate the possible association between age at menarche and diabetes prevalence in post-menopausal Korean women. This study included 3,254 post-menopausal Korean women aged 50-85 years from the Korea National Health and Nutrition Examination Survey IV (KNHANES 2007(KNHANES -2009). Logistic regression analyses were used to estimate odds ratios (ORs) for diabetes prevalence. Levels of biochemical markers were compared according to groups by age at menarche. Women in the earlier menarche age group (10-12 years) showed higher levels of fasting blood glucose (FBG) and scores of homeostatic model assessment in the insulin resistance (HOMA-IR) index than other groups (p <0.05). After adjusting for potential confounding factors, early age at menarche was significantly associated with a higher prevalence of diabetes (OR 1.86, 95% confidence intervals [CI] 1.07-3.23). The observed association remained significant despite additional adjustment for body mass index and waist circumference (OR 1.82, 95% CI 1.03-3.23) and despite further adjustments for FBG levels and HOMA-IR index (OR 2.25, 95% CI 1.11-4.55). Our findings strengthen the hypothesis that younger age at menarche is associated with increased diabetes prevalence in the Korean population.

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.…”

“…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.…”

Age at Menarche and Cardiometabolic Health: A Sibling Analysis in the Scottish Family Health Study

“…The reference group in all analyses comprised those with an age at menarche of 12 to 13 years. There is some variation across studies in the definition of early menarche (≤10, ≤11, or ≤12 years) and late menarche (≥14, ≥15, or ≥16 years), likely influenced by the size and information available in the specific study, but our categorization is in line with commonly used cutoff values 4, 5, 6, 7, 8, 10, 11, 14, 16…”

“…Early menarche is associated with reduced insulin sensitivity and higher glucose,1, 2, 3, 4, 5, 6, 7, 8, 9 higher triglycerides and cholesterol levels,2, 6, 10 higher blood pressure,4, 5, 11, 12 and greater waist circumference and body mass index (BMI) 4, 5, 13, 14, 15. In line with these findings, there is some but less consistent evidence of an association between age at menarche and cardiovascular disease (CVD) events 12, 16, 17, 18.…”