Women with early puberty at high risk of diabetes
Lower age at onset of first menstruation poses an increased risk of type 2 diabetes mellitus (T2DM) later in life, possibly driven by adult body mass index (BMI), whereas later menarche is associated with reduced diabetes risk, a study has found.
The study included 15,346 postmenopausal women. Researchers applied logistic regression and restricted cubic spline analysis to estimate the relationship between age at menarche and T2DM.
Controlled for multiple confounders, logistic regression models revealed that women in the early onset group (≤14 years) had about a 20-percent greater risk of T2DM (odds ratio [OR], 1.21, 95 percent CI, 1.06–1.38; p=0.004) compared with those whose first menstruation occurred at age 16–17 years (reference group).
Conversely, women in the late onset group (≥19 years) had a significantly lower risk of T2DM compared with those in the reference group (OR, 0.78, 0.66–0.92; p=0.003).
Mediation analysis showed that BMI partially mediated the association between age at menarche and T2DM risk, with the proportion of the effect being 28 percent.
While not clearly understood, mechanisms explaining the relationship between pubertal timing and later metabolic risk may involve LIN28B, which has been identified as the first genetic locus to be robustly associated with age at menarche, as well differential exposure to sex hormones. Specifically, early menarche is associated with higher levels of sex hormones and lower levels of sex hormone–binding globulin, which may have a role in the pathogenesis of T2DM. [Diabetes Care 2013;36:3526-3534]