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, Maria José Sanchez, 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

Research output: Contribution to journalArticle

69 Citations (Scopus)

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 confirmthis association and to examine whether it is explained by adiposity. RESEARCH DESIGN AND METHODSdThe prospective European Prospective Investigation into Cancer andNutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from26 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 latermenarche 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 earlymenarche 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 languageEnglish
Pages (from-to)3526-3534
Number of pages9
JournalDiabetes Care
Volume36
Issue number11
DOIs
Publication statusPublished - Nov 2013

Fingerprint

Menarche
Type 2 Diabetes Mellitus
Neoplasms
Adiposity
Research
Life Style
Cohort Studies
Incidence

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing
  • Medicine(all)

Cite this

Elks, C. E., Ong, K. K., Scott, R. A., Van Der Schouw, Y. T., Brand, J. S., Wark, P. A., ... Wareham, N. J. (2013). Age at menarche and type 2 diabetes risk: The EPIC-InterAct study. Diabetes Care, 36(11), 3526-3534. https://doi.org/10.2337/dc13-0446

Age at menarche and type 2 diabetes risk : The EPIC-InterAct study. / Elks, Cathy E.; Ong, Ken K.; Scott, Robert A.; Van Der Schouw, Yvonne T.; Brand, Judith S.; Wark, Petra A.; Amiano, Pilar; Balkau, Beverley; Barricarte, Aurelio; Boeing, Heiner; Fonseca-Nunes, Ana; Franks, Paul W.; Grioni, Sara; Halkjaer, Jytte; Kaaks, Rudolf; Key, Timothy J.; Khaw, Kay Tee; Mattiello, Amalia; Nilsson, Peter M.; Overvad, Kim; Palli, Domenico; Quirós, J. Ramón; Rinaldi, Sabina; Rolandsson, Olov; Romieu, Isabelle; Sacerdote, Carlotta; Sanchez, Maria José; Spijkerman, Annemieke M W; Tjonneland, Anne; Tormo, Maria Jose; Tumino, Rosario; Van Der A, Daphne L.; Forouhi, Nita G.; Sharp, Stephen J.; Langenberg, Claudia; Riboli, Elio; Wareham, Nicholas J.

In: Diabetes Care, Vol. 36, No. 11, 11.2013, p. 3526-3534.

Research output: Contribution to journalArticle

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, Sanchez, MJ, Spijkerman, AMW, Tjonneland, A, Tormo, MJ, Tumino, R, Van Der A, DL, Forouhi, NG, Sharp, SJ, Langenberg, C, Riboli, E & Wareham, NJ 2013, 'Age at menarche and type 2 diabetes risk: The EPIC-InterAct study', Diabetes Care, vol. 36, no. 11, pp. 3526-3534. https://doi.org/10.2337/dc13-0446
Elks CE, Ong KK, Scott RA, Van Der Schouw YT, Brand JS, Wark PA et al. Age at menarche and type 2 diabetes risk: The EPIC-InterAct study. Diabetes Care. 2013 Nov;36(11):3526-3534. https://doi.org/10.2337/dc13-0446
Elks, Cathy E. ; Ong, Ken K. ; Scott, Robert A. ; Van Der Schouw, Yvonne T. ; Brand, Judith S. ; Wark, Petra A. ; Amiano, Pilar ; Balkau, Beverley ; Barricarte, Aurelio ; Boeing, Heiner ; Fonseca-Nunes, Ana ; Franks, Paul W. ; Grioni, Sara ; Halkjaer, Jytte ; Kaaks, Rudolf ; Key, Timothy J. ; Khaw, Kay Tee ; Mattiello, Amalia ; Nilsson, Peter M. ; Overvad, Kim ; Palli, Domenico ; Quirós, J. Ramón ; Rinaldi, Sabina ; Rolandsson, Olov ; Romieu, Isabelle ; Sacerdote, Carlotta ; Sanchez, Maria José ; Spijkerman, Annemieke M W ; Tjonneland, Anne ; Tormo, Maria Jose ; Tumino, Rosario ; Van Der A, Daphne L. ; Forouhi, Nita G. ; Sharp, Stephen J. ; Langenberg, Claudia ; Riboli, Elio ; Wareham, Nicholas J. / Age at menarche and type 2 diabetes risk : The EPIC-InterAct study. In: Diabetes Care. 2013 ; Vol. 36, No. 11. pp. 3526-3534.
@article{537f793117a043ef827f740c6d25bc71,
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 confirmthis association and to examine whether it is explained by adiposity. RESEARCH DESIGN AND METHODSdThe prospective European Prospective Investigation into Cancer andNutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from26 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 latermenarche 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 earlymenarche 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.",
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 Sanchez, {Maria Jos{\'e}} and Spijkerman, {Annemieke M W} and Anne Tjonneland and Tormo, {Maria Jose} 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.}",
year = "2013",
month = "11",
doi = "10.2337/dc13-0446",
language = "English",
volume = "36",
pages = "3526--3534",
journal = "Diabetes Care",
issn = "1935-5548",
publisher = "American Diabetes Association Inc.",
number = "11",

}

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 - Sanchez, Maria 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.

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 confirmthis association and to examine whether it is explained by adiposity. RESEARCH DESIGN AND METHODSdThe prospective European Prospective Investigation into Cancer andNutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from26 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 latermenarche 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 earlymenarche 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 confirmthis association and to examine whether it is explained by adiposity. RESEARCH DESIGN AND METHODSdThe prospective European Prospective Investigation into Cancer andNutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from26 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 latermenarche 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 earlymenarche 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.

UR - http://www.scopus.com/inward/record.url?scp=84891868620&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84891868620&partnerID=8YFLogxK

U2 - 10.2337/dc13-0446

DO - 10.2337/dc13-0446

M3 - Article

C2 - 24159179

AN - SCOPUS:84891868620

VL - 36

SP - 3526

EP - 3534

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 11

ER -