title: Age at menarche is associated with prediabetes and diabetes in women (aged 32-81 years) from the general population: the KORA F4 Study.
abstract: OBJECTIVE
  The aim of this study was to examine the association between age at menarche and prediabetes as well as diabetes, considering confounding factors and the possible mediating role of adult obesity.
  
  
  METHODS
  This cross-sectional study analysed data on 1,503 women aged 32-81 years from the German population-based KORA (Cooperative Health Research in the Region of Augsburg, South Germany) F4 Study (2006-2008). Data were collected by standardised interviews, physical examinations, and whole blood and serum measurements, including administration of an OGTT in non-diabetic participants.
  
  
  RESULTS
  Of the 1,503 women, 226 showed a prediabetic state (impaired fasting glucose and/or impaired glucose tolerance) and 140 persons had diabetes (45 participants with previously undiagnosed diabetes and 95 with known diabetes). In Poisson regression analysis, age at menarche was significantly inversely associated with prediabetes or diabetes after adjustment for year of birth (RR 0.88; 95% CI 0.82, 0.94, p < 0.0001 per additional year of menarche) and after additional adjustment for a number of confounding factors (RR 0.88; 95% CI 0.83, 0.94, p = 0.0001). Further adjustment for current BMI slightly attenuated the association with prediabetes or diabetes (RR 0.89; 95% CI 0.83, 0.95, p = 0.0009), but the association remained clearly significant.
  
  
  CONCLUSIONS
  Age at menarche seems to be inversely associated with prediabetes and diabetes independent of confounding factors including current BMI. Women at risk for diabetes might be identified by a history of young age at menarche.
authors.affiliation: Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr 1, D-85764 Neuherberg, Germany. doris.stoeckl@helmholtz-muenchen.de
authors.forename: D
authors.initials: D
authors.lastname: Stöckl
authors.forename: A
authors.initials: A
authors.lastname: Döring
authors.forename: A
authors.initials: A
authors.lastname: Peters
authors.forename: B
authors.initials: B
authors.lastname: Thorand
authors.forename: M
authors.initials: M
authors.lastname: Heier
authors.forename: C
authors.initials: C
authors.lastname: Huth
authors.forename: H
authors.initials: H
authors.lastname: Stöckl
authors.forename: W
authors.initials: W
authors.lastname: Rathmann
authors.forename: B
authors.initials: B
authors.lastname: Kowall
authors.forename: C
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006442:Glycated Hemoglobin / Q000032:analysis; D006306:Health Surveys; D006801:Humans; D008572:Menarche; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D011236:Prediabetic State / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011629:Puberty, Precocious / Q000503:physiopathology; D012720:Severity of Illness Index
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human