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

Elks, Cathy E.; Ong, Ken K.; Scott, Robert A.; van der Schouw, Yvonne T.; Brand, Judith S.; Wark, Petra A.; Amiano, Pilar; Balkau, Beverley; Barricarte, Aurelio and Boeing, Heiner, et al. (2013) In Diabetes Care 36(11). p.3526-3534
Abstract
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... (More)
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. (Less)
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Contribution to journal
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published
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Diabetes Care
volume
36
issue
11
pages
3526 - 3534
publisher
American Diabetes Association
external identifiers
  • wos:000326274100030
  • scopus:84891868620
ISSN
1935-5548
DOI
10.2337/dc13-0446
language
English
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yes
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0d6132f2-0669-47d8-b54b-c9ef96581a1a (old id 4204411)
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2014-01-03 10:42:22
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2019-11-05 02:37:57
@article{0d6132f2-0669-47d8-b54b-c9ef96581a1a,
  abstract     = {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 &lt; 0.001). Adjustment for BMI partially attenuated this association (HR, 1.42; 95% CI, 1.18-1.71; P &lt; 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.},
  author       = {Elks, Cathy E. and Ong, Ken K. and Scott, Robert A. and van der Schouw, Yvonne T. and Brand, Judith S. and Wark, Petra A. and Amiano, Pilar and Balkau, Beverley and Barricarte, Aurelio and Boeing, Heiner and Fonseca-Nunes, Ana and Franks, Paul and Grioni, Sara and Halkjaer, Jytte and Kaaks, Rudolf and Key, Timothy J. and Khaw, Kay Tee and Mattiello, Amalia and Nilsson, Peter and Overvad, Kim and Palli, Domenico and Quiros, J. Ramon and Rinaldi, Sabina and Rolandsson, Olov and Romieu, Isabelle and Sacerdote, Carlotta and Sanchez, Maria-Jose and Spijkerman, Annemieke M. W. and Tjonneland, Anne and Tormo, Maria-Jose and Tumino, Rosario and Daphne, L. Van der A. and Forouhi, Nita G. and Sharp, Stephen J. and Langenberg, Claudia and Riboli, Elio and Wareham, Nicholas J.},
  issn         = {1935-5548},
  language     = {eng},
  number       = {11},
  pages        = {3526--3534},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {Age at Menarche and Type 2 Diabetes Risk The EPIC-InterAct study},
  url          = {http://dx.doi.org/10.2337/dc13-0446},
  volume       = {36},
  year         = {2013},
}