title: Adolescent oligomenorrhea in a biracial schoolgirl cohort: a simple clinical parameter predicting impaired fasting glucose plus type 2 diabetes mellitus, insulin, glucose, insulin resistance, and centripetal obesity from age 19 to 25 years.
abstract: We hypothesized that adolescent oligomenorrhea (ages 14-19) would independently predict impaired fasting glucose (IFG; ≥110 to <126 mg/dL) plus type 2 diabetes mellitus (T2DM; ≥126 mg/dL), insulin and glucose levels, and insulin resistance (IR) in young adulthood (ages 19-25). A prospective 15-year follow-up of 370 schoolgirls starting at age 10 was performed. Age 14 waist circumference was the most important explanatory variable for IFG + T2DM during ages 19 to 24 (P = .002; odds ratio, 1.06; 95% confidence interval, 1.02-1.10), along with oligomenorrhea category from ages 14 to 19 (0, 1, 2, ≥3 reports over 6 years; P = .032; odds ratio, 1.82; 95% confidence interval, 1.05-3.14). Impaired fasting glucose + T2DM at ages 19 to 24 were more common in girls having 1 (6%), 2 (11%), and ≥3 (38%) oligomenorrhea reports from ages 14 to 19 than in girls without oligomenorrhea (3%; P = .0003). Positive explanatory variables (all Ps ≤ .05) for homeostasis model assessment of IR at ages 19 to 24 included age 14 waist (partial R(2) = 30.1%), oligomenorrhea with hyperandrogenism (polycystic ovary syndrome; partial R(2) = 4.1%), black race (3.8%), and oligomenorrhea frequency during ages 14 to 19 (0.8%); sex hormone binding globulin was a negative explanatory variable (0.7%). This is the first prospective study to report an independent association of adolescent oligomenorrhea with young adult IFG + T2DM, with insulin and glucose levels, and with IR. Age 14 waist circumference, oligomenorrhea with hyperandrogenism (polycystic ovary syndrome), black race, oligomenorrhea frequency at ages 14 to 19, and age 14 sex hormone binding globulin were independently associated with IR at ages 19 to 24, potentially facilitating primary prevention of IFG, T2DM, and hyperinsulinemia.
authors.affiliation: Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
authors.forename: John A
authors.initials: JA
authors.lastname: Morrison
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Glueck
authors.forename: Stephen
authors.initials: S
authors.lastname: Daniels
authors.forename: Ping
authors.initials: P
authors.lastname: Wang
authors.forename: Davis
authors.initials: D
authors.lastname: Stroop
mesh_terms: D000293:Adolescent; D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D015992:Body Mass Index; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000209:etiology*; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D024821:Metabolic Syndrome / Q000209:etiology; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D009839:Oligomenorrhea / Q000150:complications* / Q000378:metabolism; D011085:Polycystic Ovary Syndrome / Q000378:metabolism; D011446:Prospective Studies; D012738:Sex Hormone-Binding Globulin / Q000032:analysis
chemical_list: D001786:Blood Glucose; D007328:Insulin; D012738:Sex Hormone-Binding Globulin