Age at menarche and type 2 diabetes risk: the EPIC-InterAct study

Cathy E Elks; Ken K Ong; Robert A Scott; Yvonne T van der Schouw; Judith S Brand; Petra A Wark; Pilar Amiano; Beverley Balkau; Aurelio Barricarte; Heiner Boeing; Ana Fonseca-Nunes; Paul W Franks; Sara Grioni; Jytte Halkjaer; Rudolf Kaaks; Timothy J Key; Kay Tee Khaw; Amalia Mattiello; Peter M Nilsson; Kim Overvad; Domenico Palli; J Ramón Quirós; Sabina Rinaldi; Olov Rolandsson; Isabelle Romieu; Carlotta Sacerdote; María-José Sánchez; Annemieke M W Spijkerman; Anne Tjonneland; Maria-Jose Tormo; Rosario Tumino; Daphne L van der A; Nita G Forouhi; Stephen J Sharp; Claudia Langenberg; Elio Riboli; Nicholas J Wareham; InterAct Consortium

doi:10.2337/dc13-0446

Age at menarche and type 2 diabetes risk: the EPIC-InterAct study

Cathy E Elks, Ken K Ong, Robert A Scott, Yvonne T van der Schouw, Judith S Brand, Petra A Wark, Pilar Amiano, Beverley Balkau, Aurelio Barricarte, Heiner Boeing, Ana Fonseca-Nunes, Paul W Franks, Sara Grioni, Jytte Halkjaer, Rudolf Kaaks, Timothy J Key, Kay Tee Khaw, Amalia Mattiello, Peter M Nilsson, Kim OvervadDomenico Palli, J Ramón Quirós, Sabina Rinaldi, Olov Rolandsson, Isabelle Romieu, Carlotta Sacerdote, María-José Sánchez, Annemieke M W Spijkerman, Anne Tjonneland, Maria-Jose Tormo, Rosario Tumino, Daphne L van der A, Nita G Forouhi, Stephen J Sharp, Claudia Langenberg, Elio Riboli, Nicholas J Wareham, InterAct Consortium

Research output: Contribution to journal › Article (Academic Journal) › peer-review

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Abstract

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/m2 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.

Original language	English
Pages (from-to)	3526-34
Number of pages	9
Journal	Diabetes Care
Volume	36
Issue number	11
DOIs	https://doi.org/10.2337/dc13-0446
Publication status	Published - Nov 2013

Keywords

Adiposity
Adult
Age Factors
Diabetes Mellitus, Type 2
Europe
Female
Humans
Incidence
Life Style
Longitudinal Studies
Menarche
Middle Aged
Neoplasms
Obesity
Prospective Studies
Risk
Risk Factors
Journal Article
Research Support, Non-U.S. Gov't

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2337/dc13-0446

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Elks, C. E., Ong, K. K., Scott, R. A., van der Schouw, Y. T., Brand, J. S., Wark, P. A., Amiano, P., Balkau, B., Barricarte, A., Boeing, H., Fonseca-Nunes, A., Franks, P. W., Grioni, S., Halkjaer, J., Kaaks, R., Key, T. J., Khaw, K. T., Mattiello, A., Nilsson, P. M., ... InterAct Consortium (2013). Age at menarche and type 2 diabetes risk: the EPIC-InterAct study. Diabetes Care, 36(11), 3526-34. https://doi.org/10.2337/dc13-0446

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title = "Age at menarche and type 2 diabetes risk: the EPIC-InterAct study",

abstract = "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/m2 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.",

keywords = "Adiposity, Adult, Age Factors, Diabetes Mellitus, Type 2, Europe, Female, Humans, Incidence, Life Style, Longitudinal Studies, Menarche, Middle Aged, Neoplasms, Obesity, Prospective Studies, Risk, Risk Factors, Journal Article, Research Support, Non-U.S. Gov't",

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 Pilar Amiano and Beverley Balkau and Aurelio Barricarte and Heiner Boeing and Ana Fonseca-Nunes and Franks, {Paul W} and Sara Grioni and Jytte Halkjaer and Rudolf Kaaks and Key, {Timothy J} and Khaw, {Kay Tee} and Amalia Mattiello and Nilsson, {Peter M} and Kim Overvad and Domenico Palli and Quir{\'o}s, {J Ram{\'o}n} and Sabina Rinaldi and Olov Rolandsson and Isabelle Romieu and Carlotta Sacerdote and Mar{\'i}a-Jos{\'e} S{\'a}nchez and Spijkerman, {Annemieke M W} and Anne Tjonneland and Maria-Jose Tormo and Rosario Tumino and {van der A}, {Daphne L} and Forouhi, {Nita G} and Sharp, {Stephen J} and Claudia Langenberg and Elio Riboli and Wareham, {Nicholas J} and {InterAct Consortium}",

year = "2013",

month = nov,

doi = "10.2337/dc13-0446",

language = "English",

volume = "36",

pages = "3526--34",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association Inc.",

number = "11",

}

Elks, CE, Ong, KK, Scott, RA, van der Schouw, YT, Brand, JS, Wark, PA, Amiano, P, Balkau, B, Barricarte, A, Boeing, H, Fonseca-Nunes, A, Franks, PW, Grioni, S, Halkjaer, J, Kaaks, R, Key, TJ, Khaw, KT, Mattiello, A, Nilsson, PM, Overvad, K, Palli, D, Quirós, JR, Rinaldi, S, Rolandsson, O, Romieu, I, Sacerdote, C, Sánchez, M-J, Spijkerman, AMW, Tjonneland, A, Tormo, M-J, Tumino, R, van der A, DL, Forouhi, NG, Sharp, SJ, Langenberg, C, Riboli, E, Wareham, NJ & InterAct Consortium 2013, 'Age at menarche and type 2 diabetes risk: the EPIC-InterAct study', Diabetes Care, vol. 36, no. 11, pp. 3526-34. https://doi.org/10.2337/dc13-0446

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, Peter M

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/m2 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/m2 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.

KW - Adiposity

KW - Adult

KW - Age Factors

KW - Diabetes Mellitus, Type 2

KW - Europe

KW - Female

KW - Humans

KW - Incidence

KW - Life Style

KW - Longitudinal Studies

KW - Menarche

KW - Middle Aged

KW - Neoplasms

KW - Obesity

KW - Prospective Studies

KW - Risk

KW - Risk Factors

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.2337/dc13-0446

DO - 10.2337/dc13-0446

M3 - Article (Academic Journal)

C2 - 24159179

SN - 0149-5992

VL - 36

SP - 3526

EP - 3534

JO - Diabetes Care

JF - Diabetes Care

IS - 11

ER -

Age at menarche and type 2 diabetes risk: the EPIC-InterAct study

Abstract

Keywords

UN SDGs

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