Early and late menarche are associated with oligomenorrhea and predict metabolic syndrome 26 years later

Metabolism. 2013 Nov;62(11):1597-606. doi: 10.1016/j.metabol.2013.07.005. Epub 2013 Aug 15.

Abstract

Objective: We determined whether simple, clinical information on late and early menarche could help identify adult women with metabolic syndrome (MetS) and oligomenorrhea.

Materials/methods: We carried out a 26-year prospective follow-up of 272 suburban schoolgirls from ages 5-22 to 30-46.

Results: Early menarche (≤10 years, 5.2% of girls) and late menarche (≥16 years, 6.7% of girls) were both associated with oligomenorrhea (≥42 days) in adulthood, 29% and 11%, vs. 5% for normal menarche (11-15 years), p=.004. Early menarche was characterized by high childhood BMI (LS mean±SE: 21.2 ±1.0 kg/m2) and by high childhood and adult MetS (15%, 36%). Girls with late menarche had the lowest childhood BMI (18.1±1.0), no childhood MetS, and the highest adult MetS (47%). Increasing age at menarche was associated with uniformly decreasing childhood BMI and MetS, but with a U-shaped pattern of BMI (p = .05), MetS (p=.008), and oligomenorrhea (p=.02) in adulthood. Change to MetS from median ages 13 to 38 was associated with early-late menarche (OR=3.11, 95% CI 1.37-7.07, p=.007). MetS in adulthood was associated with childhood MetS (OR=8.03, 95% CI 2.57-25.08, p=.0003) and with early-late menarche (OR =3.43, 95% CI 1.44-8.15, p=.005).

Conclusions: Menarche age had a curvilinear ('U' shaped) relationship with MetS and oligomenorrhea in adulthood. Late menarche and early menarche are risk factors for adult oligomenorrhea, MetS, and cardiometabolic abnormalities. Girls with early (≤ age 10) and with late menarche (≥ 16) represent a group at high risk for adult cardiometabolic abnormalities and oligomenorrhea that is easily identifiable by physicians.

Keywords: 95% CI; 95% confidence intervals; BMI; Body mass index; Cardiometabolic abnormalities; DBP; Early menarche; HDLC; LDLC; LRC; Late menarche; Lipid Research Clinics; MetS; Metabolic syndrome; OR; Oligomenorrhea; PFS; Princeton Follow-up Study; SBP; TG; diastolic blood pressure; high density lipoprotein cholesterol; low-density lipoprotein cholesterol; odds ratio; systolic blood pressure; triglyceride.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • Child
  • Child, Preschool
  • Cholesterol, HDL / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Logistic Models
  • Menarche*
  • Metabolic Syndrome / epidemiology*
  • Metabolic Syndrome / etiology
  • Middle Aged
  • Odds Ratio
  • Oligomenorrhea / epidemiology*
  • Oligomenorrhea / etiology
  • Predictive Value of Tests
  • Prospective Studies
  • Risk Factors
  • Time Factors
  • Triglycerides / blood
  • United States / epidemiology
  • Young Adult

Substances

  • Biomarkers
  • Blood Glucose
  • Cholesterol, HDL
  • Triglycerides