title: Early age at menarche: a risk factor for overweight or obesity in patients with type 1 diabetes living in urban areas?
abstract: OBJECTIVE
  Determine the relationship between age at menarche, glycemic control and cardiovascular risk factors in patients with type 1 diabetes living in urban areas.
  
  
  METHODS
  This was a multicenter cross-sectional study conducted in 20 cities in four Brazilian geographic regions. Data were obtained from 1527 female patients, 59.3% Caucasians, aged 25.1 ± 10.6 years. Diabetes duration was 11.4 ± 8.1 years. Age at menarche was stratified in four groups: 8-11 (group 1, early menarche), 12 (group 2), 13 (group 3) and 14-18 years (group 4, late menarche).
  
  
  RESULTS
  The mean age at menarche was 12.7 ± 1.7 years without difference among geographical regions, economic status, level of care and ethnicity. BMI had an inverse correlation with age at menarche (r=-0.14, p<0.001). No significant difference was observed among the four groups for blood pressure, lipid profile and diabetes-related chronic complications. Logistic regression analysis showed that early age at menarche, 8-11 years (odds ratio (ORs) 1.77 [1.30-2.41], p<0.001) and duration of diabetes [ORs 1.01 (1.00-1.03), p=0.02], were related to greater risk of patients' overweight or obesity; adherence to diet [ORs 0.78 (0.60-0.93), p=0.01], physical activity [ORs 0.75 (0.94-0.94), p=0.01], and lower insulin dose (U/kg) [ORs 0.54 (0.59-0.90), p=0.001] were related to lower risk for overweight or obesity.
  
  
  CONCLUSIONS
  Early menarche occurred in 23.4% of women with type 1 diabetes living in Brazilian urban areas and was strongly associated with overweight/obesity in pubertal/adult life. Further studies are warranted to establish the relationship between early menarche, glycemic control and cardiovascular risk factors.
authors.affiliation: Department of Internal Medicine, Diabetes Unit, State University of Rio de Janeiro, Brazil.
authors.forename: M B
authors.initials: MB
authors.lastname: Gomes
authors.affiliation: Bauru's Diabetics Association, Bauru, São Paulo, Brazil. Electronic address: carlosnegrato@uol.com.br.
authors.forename: C A
authors.initials: CA
authors.lastname: Negrato
authors.affiliation: Pediatric Endocrine Unit, Santa Casa School of Medical Sciences, São Paulo, SP, Brazil.
authors.forename: L E P
authors.initials: LE
authors.lastname: Calliari
mesh_terms: D000328:Adult; D000367:Age Factors; D001938:Brazil / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008572:Menarche / Q000502:physiology*; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D012307:Risk Factors; D014505:Urban Population
keywords: Age at menarche; Cardiovascular risk factors; Glycemic control; Obesity; Type 1 diabetes