Age at Menarche and Cardiometabolic Risk in Adulthood: The Coronary Artery Risk Development in Young Adults Study

Abstract

Objective: To examine the association of menarche timing with cardiometabolic risk factors into early to mid-adulthood, comparing African American and White women.

Study design: Analyses included 2583 women (African American = 1333; White = 1250) from the Coronary Artery Risk Development in Young Adults cohort study over 25 years of follow-up (1985-2011). Outcomes included type 2 diabetes, metabolic syndrome, adiposity, glucose, insulin, blood pressure, and blood lipids. Cox models or repeated measures linear regression models estimated the association between age at menarche and the outcomes.

Results: Each 1-year earlier age at menarche was associated with higher mean body mass index among African American (0.88 ± 0.12 kg/m(2), P < .0001) and White (0.89 ± 0.10 kg/m(2), P < .0001) women. After body mass index adjustment, each 1-year earlier age at menarche was associated with higher triglycerides (2.26 ± 0.68 mg/dL, P = .001) and glucose (0.34 ± 0.11 mg/dL, P = .002), and greater risk for incident impaired fasting glucose (hazard ratio = 1.13, 95% CI 1.04-1.20) and metabolic syndrome (hazard ratio 1.19, 95% CI 1.11-1.26) among White women only.

Conclusions: Excess adiposity associated with earlier menarche is sustained through mid-adulthood, and primarily drives higher cardiometabolic risk factor levels. However, White women with earlier menarche had increased risk of a number of insulin-resistance related conditions independent of adiposity. The cardiometabolic impact of earlier menarche was weaker in African American women despite higher average adiposity. Weight maintenance would likely reduce but may not completely eliminate the elevated cardiometabolic risk of earlier menarche.

Conflict of interest statement

The other authors declare no conflicts of interest.

Copyright © 2015 Elsevier Inc. All rights reserved.

Figures

Figure 1

Adjusted* mean adiposity levels during adulthood by age at menarche category in the CARDIA Study Legend: Early Average Late Notes: Includes women who reported menarche 8–17 years, were non-diabetic at baseline, and who had data available on covariates. Excludes the visits for women who were pregnant or developed diabetes. *Adjusted for age, age2, and clinical center