Early menarche tied to higher risk for type 2 diabetes mellitus

  • Cheng TS & al.
  • PLoS Med
  • 1 Jan 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • This meta-analysis found a higher risk for type 2 diabetes mellitus (T2DM) and impaired glucose tolerance (IGT) among women with early menarche vs later menarche, independent of adiposity.
  • This risk is even higher in white than Asian women and in population with a younger average age at menarche (AAM).

Why this matters

  • Findings suggest that preventive strategies that avoid early puberty timing might lower future risk for T2DM.

Study design

  • Meta-analysis of 28 studies (n=1,228,306) that evaluated AAM among women and T2DM/IGT.
  • Funding: None disclosed.

Key results

  • In models without adjustment for adult adiposity:
    •  later AAM was associated with a lower risk for T2DM/IGT (relative risk [RR], 0.91 [95% CI, 0.89-0.93] per year; I2=85.4%) and
    • early menarche was associated with a higher risk for T2DM/IGT (RR, 1.39 [95% CI, 1.25-1.55] per year; I2=89.4%).
  • In models adjusted for adiposity, this associations were weaker but still evident:
    • later AAM: RR, 0.97 [95% CI, 0.95-0.98] per year; I2=51.8% and
    •  early menarche: RR, 1.19 [95% CI, 1.11-1.28] per year; I2=68.1%).
  • The risk for T2DM/IGT associated with early menarche was higher among white than Asian women and in populations with younger than older average AAM.
  • In white UK women, the estimated population attributable risk because of early menarche unadjusted and adjusted for adiposity was 12.6% (95% CI, 11.0-14.3%) and 5.1% (95% CI, 3.6-6.7%), respectively.

Limitations

  • Risk of residual confounding.
  • Heterogeneity among included studies.