Early Menstrual Factors Are Associated with Adulthood Cardio-Metabolic Health in a Survey of Mexican Teachers
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Objectives To evaluate whether age at menarche and time to menstrual regularity were related to cardio-metabolic risk factors in Mexican women. Methods The study population comprised 54,921 women from the 2008–2010 wave of the Mexican Teacher’s Cohort. A modified Poisson approach was used; exposures were age at menarche and time to menstrual regularity (< 1 year vs. ≥1 year), and outcomes were prevalent obesity, type 2 diabetes, high blood pressure, and high cholesterol. Results Mean (SD) age of women was 42.1 (7.6) years, and mean (SD) menarcheal age was 12.5 (1.5) years. Compared to women with menarche age 13 years, those with menarche < 9 years had a 65% (95% CI 43–90%); 27% (95% CI 4–55%); and 23% (95% CI 1–49%) higher prevalence of obesity, high blood pressure, and high cholesterol, respectively. For diabetes, there was a U-shaped association; compared to menarche age 13 years, those with menarche < 9 years had an 89% higher prevalence of diabetes (95% CI 39–156%), and those with menarche ≥ 17 years had a 65% higher prevalence (95% CI 16–134%). Among women with regular cycles (n = 43,113), a longer time to menstrual regularity was associated with diabetes (PR = 1.11 with 95% CI 1.02–1.22), high blood pressure (PR = 1.11 with 95% CI 1.06–1.17), and high cholesterol (PR = 1.09 with 95% CI 1.04–1.14). Conclusions for practice Mexican women with earlier and later ages at menarche and/or longer time to menstrual regularity may have higher risk of cardio-metabolic disease in adulthood.
KeywordsMenarche Time to menstrual regularity Obesity Type 2 diabetes High blood pressure High cholesterol
We gratefully acknowledge Antonio García-Anaya, and Eduardo Ortiz-Panozo for data management expertise and assistance. We thank ISSSTE (Social Security and Services Institute for Employees of the State) for technical and administrative support. We also wish to thank the participants of the Mexican Teachers’ Cohort. Without their participation, this study would not have been possible. R. López-Ridaura and M. Lajous have a nonrestricted investigator-initiated grant from AstraZeneca. E. Jansen is supported by funding from the National Institute of Diabetes and Digestive and Kidney Diseases (5T32DK071212-12). This work is also supported by the American Institute for Cancer Research (05B047), and Consejo Nacional de Ciencia y Tecnología (S0008-2009-1:000000000115312).
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Conflict of interest
The authors declare they have no conflict of interest.
- Barros, A. J. D., & Hirakata, V. N. (2003). Alternatives for logistic regression in cross-sectional studies: An empirical comparison of models that directly estimate the prevalence ratio. BMC Medical Research Methodology, 3, 21. https://doi.org/10.1186/1471-2288-3-21.CrossRefPubMedPubMedCentralGoogle Scholar
- Boyne, M. S., Thame, M., Osmond, C., Fraser, R. A., Gabay, L., Taylor-Bryan, C., & Forrester, T. E. (2014). The effect of earlier puberty on cardiometabolic risk factors in Afro-Caribbean children. Journal of Pediatric Endocrinology and Metabolism, 27(5–6), 453–460. https://doi.org/10.1515/jpem-2013-0324.CrossRefPubMedGoogle Scholar
- Canoy, D., Beral, V., Balkwill, A., Wright, F. L., Kroll, M. E., Reeves, G. K., … Young, H. (2015). Age at menarche and risks of coronary heart and other vascular diseases in a large UK cohort. Circulation, 131(3), 237–244. https://doi.org/10.1161/CIRCULATIONAHA.114.010070.CrossRefPubMedGoogle Scholar
- Dreyfus, J., Jacobs, D. R., Mueller, N., Schreiner, P. J., Moran, A., Carnethon, M. R., & Demerath, E. W. (2015). Age at menarche and cardiometabolic risk in adulthood: The coronary artery risk development in young adults study. The Journal of Pediatrics, 167(2), 344–352.e1. https://doi.org/10.1016/j.jpeds.2015.04.032.CrossRefPubMedPubMedCentralGoogle Scholar
- Dreyfus, J. G., Lutsey, P. L., Huxley, R., Pankow, J. S., Selvin, E., Fernández-Rhodes, L., … Demerath, E. W. (2012). Age at menarche and risk of type 2 diabetes among African-American and white women in the Atherosclerosis Risk in Communities (ARIC) study. Diabetologia, 55(9), 2371–2380. https://doi.org/10.1007/s00125-012-2616-z.CrossRefPubMedPubMedCentralGoogle Scholar
- Ester, W. A., Houghton, L. C., Lumey, L. H., Michels, K. B., Hoek, H. W., Wei, Y., … Terry, M. B. (2017). Maternal and early childhood determinants of women’s body size in midlife: Overall cohort and sibling analyses. American Journal of Epidemiology, 185(5), 385–394. https://doi.org/10.1093/aje/kww222.CrossRefPubMedPubMedCentralGoogle Scholar
- Lim, S. W., Ahn, J. H., Lee, J. A., Kim, D. H., Seo, J. H., & Lim, J. S. (2016). Early menarche is associated with metabolic syndrome and insulin resistance in premenopausal Korean women. European Journal of Pediatrics, 175(1), 97–104. https://doi.org/10.1007/s00431-015-2604-7.CrossRefPubMedGoogle Scholar
- Meza, R., Barrientos-Gutierrez, T., Rojas-Martinez, R., Reynoso-Noverón, N., Palacio-Mejia, L. S., Lazcano-Ponce, E., & Hernández-Ávila, M. (2015). Burden of type 2 diabetes in Mexico: Past, current and future prevalence and incidence rates. Preventive Medicine, 81, 445–450. https://doi.org/10.1016/j.ypmed.2015.10.015.CrossRefPubMedPubMedCentralGoogle Scholar
- Mueller, N. T., Duncan, B. B., Barreto, S. M., Chor, D., Bessel, M., Aquino, E. M., … Schmidt, M. (2014). Earlier age at menarche is associated with higher diabetes risk and cardiometabolic disease risk factors in Brazilian adults: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cardiovascular Diabetology, 13(1), 22. https://doi.org/10.1186/1475-2840-13-22.CrossRefPubMedPubMedCentralGoogle Scholar
- Palloni, A., Beltrán-Sánchez, H., Novak, B., Pinto, G., & Wong, R. (2015). Adult obesity, disease and longevity in Mexico. Salud Publica de Mexico, 57 Suppl 1(01), S22–S30. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/26172231.
- Rohrer, T., Stierkorb, E., Heger, S., Karges, B., Raile, K., Schwab, K. O., & Holl, R. W. (2007). Delayed pubertal onset and development in German children and adolescents with type 1 diabetes: Cross-sectional analysis of recent data from the DPV diabetes documentation and quality management system. European Journal of Endocrinology, 157(5), 647–653. https://doi.org/10.1530/EJE-07-0150.CrossRefPubMedGoogle Scholar
- Rostami Dovom, M., Ramezani Tehrani, F., Djalalinia, S., Cheraghi, L., Gandavani, B. S., & Azizi, F. (2016). Menstrual cycle irregularity and metabolic disorders: A population-based prospective study. PLoS ONE, 11(12), e0168402. https://doi.org/10.1371/journal.pone.0168402.CrossRefPubMedPubMedCentralGoogle Scholar
- Sim, J. H., Chung, D., Lim, J. S., Lee, M. Y., Chung, C. H., Shin, J. Y., & Huh, J. H. (2015). Maternal age at first delivery is associated with the risk of metabolic syndrome in postmenopausal women: From 2008 to 2010 Korean National Health and Nutrition Examination Survey. PLoS ONE, 10(5), e0127860. https://doi.org/10.1371/journal.pone.0127860.CrossRefPubMedPubMedCentralGoogle Scholar
- Tanner, J. M. (1992). Growth as a measure of the nutritional and hygienic status of a population. Hormone Research, 38 Suppl 1, 106–115. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/1295807.