Association between age at menarche and risk of diabetes: results from the EPIC-Norfolk cohort
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This population-based prospective cohort-study was based on the hypothesis that earlier age at menarche, a state associated with ischaemic heart disease, breast cancer as well as increased adult weight and obesity, would predict subsequent diabetes risk. To this end, 13,308 women aged 40 to 75 years from the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk) were included in the study, and data on age at menarche by recall and on ascertained diabetes incidence using multiple sources of information up to 2005 were analysed. A total of 734 cases of diabetes were observed. In women with diabetes, mean age at menarche was lower than in those without diabetes. Compared with the earliest quintile, women in the oldest quintile had lower BMI and a reduced risk of diabetes. The association between age at menarche and diabetes appeared to be linear and completely mediated by adult BMI and/or waist circumference. In conclusion, earlier age at menarche appears to increase the risk of diabetes, which is partially mediated by increased adiposity. Therefore, history of early menarche may help to identify women with increased risk of diabetes in later life.
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