Background: Diabetes and diabetes complications are on the rise in U.S. adults under 65 years, while younger onset of menarche is also increasing. We examined the associations of menarche age with type 2 diabetes and with cardiovascular disease (CVD) complications among women with diabetes.

Methods: In the cross-sectional National Health and Nutrition Examination Survey (NHANES) 1999-2016, women aged 20-65 years free of cancer were included. CVD was defined as coronary heart disease and stroke.

Results: Of 15,619 participants, 1,545 (9.9%) reported having type 2 diabetes. Earlier age at menarche was associated with type 2 diabetes, compared to median menarche age 13 years, after multiple adjustment (Table). Among women with diabetes, earlier age at menarche was associated with CVD (Table). The association of earlier age at menarche was more pronounced with stroke among women with diabetes (table). When race stratified, the association between extremely early age at menarche (≤10 years) remained significantly associated with CVD among non-white women with diabetes (OR 2.27 [95% CI 1.11-4.62]), while the association among white women was attenuated (1.95 [0.88-4.30]).

Conclusion: Earlier age at menarche was associated with type 2 diabetes and with CVD among young and middle-aged women living with diabetes in the U.S.


S.H. Ley: None. Y. Li: None. K.M. Rexrode: None. A. Eliassen: None. J.D. Bundy: None. J. He: None. L.A. Bazzano: None.


National Institutes of Health (P20GM109036)

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