title: Association of age at menarche with metabolic syndrome and its components in rural Bangladeshi women.
abstract: BACKGROUND
  Early age at menarche is associated with increased risk of metabolic syndrome in both China and the West. However, little is known about the impact of age at menarche and metabolic syndrome in South Asian women, including those from low-income country, where age at menarche is also falling. The aim of the present study was to investigate whether age at menarche is inversely associated with metabolic syndrome in Bangladeshi women, who are mostly poor and have limited access to and or poor health care facilities.
  
  
  METHODS
  This community-based cross-sectional study was performed using 1423 women aged between 15-75 years from rural Bangladesh in 2009 and 2010. Metabolic syndrome was defined according to standard NCEP-ATP III criteria. Logistic regression was used to estimate the association between age at menarche and metabolic syndrome, with adjustment of potential confounding variables, including age, education, marital status, tobacco users, use of contraceptives and number of pregnancies.
  
  
  RESULTS
  Early onset of menarche (<12 years) as compared to late onset (>13 years) was found to be associated with a higher prevalence of metabolic syndrome (odds ratio=1.55; 95 % confidence interval =1.05-2.30). Age at onset of menarche was also inversely associated with prevalence of high triglycerides (P for trend <0.01) and low high-density lipoprotein cholesterol (P for trend = 0.01), but positively associated with prevalence of high fasting blood glucose (P for trend =0.02). However, no significant association was found between age at menarche, high blood pressure and elevated waist circumference.
  
  
  CONCLUSIONS
  Early onset of menarche might promote or trigger development of metabolic syndrome. Thus, knowledge of the history of age at onset of menarche may be critical in identifying women at risk of developing metabolic syndrome and those likely to benefit the most from early interventions.
authors.affiliation: Health & Disease Research Center for Rural Peoples (HDRCRP), 14/15, 1st Floor, Probal Housing Ltd,, Shekertak (Adjacent to Shekertak Road 1), Mohammadpur, Dhaka 1207, Bangladesh. jsubrina@hdrcrp.org.
authors.forename: Shamima
authors.initials: S
authors.lastname: Akter
authors.forename: Subrina
authors.initials: S
authors.lastname: Jesmin
authors.forename: Mazedul
authors.initials: M
authors.lastname: Islam
authors.forename: Sayeeda Nusrat
authors.initials: SN
authors.lastname: Sultana
authors.forename: Osamu
authors.initials: O
authors.lastname: Okazaki
authors.forename: Michiaki
authors.initials: M
authors.lastname: Hiroe
authors.forename: Masao
authors.initials: M
authors.lastname: Moroi
authors.forename: Taro
authors.initials: T
authors.lastname: Mizutani