Early menarche has been associated with a higher risk of metabolic syndrome (MetS), CVD and its risk factors in the general population. However, limited data exists regarding the association between age at menarche and MetS in women with type 1 diabetes (T1D), a population in which menarche may be delayed. We thus assessed the ability of age at menarche to predict incident MetS in female participants (n=235) of the EDC study, a cohort of childhood onset T1D. MetS was defined using modified AHA NCEP ATP III criteria: waist circumference ≥ 89 cm; triglycerides ≥ 150 mg/dL or treatment for elevated triglycerides; HDL cholesterol < 50 mg/dL; systolic/diastolic blood pressure ≥130/85 mmHg or on antihypertensive medications. Since all participants met the criteria of hyperglycemia, any two of the remaining four criteria were required for diagnosis of MetS. Participants were divided into 3 menarche timing groups: early (≤11 years, n=22), normal (12∼14 years, n=163) and delayed menarche (≥15 years, n=50). At baseline, women with delayed menarche were with longer diabetes duration and more likely to have lower estimated glomerular filtration rate (eGFR) compared with the other groups (all p-values<0.05). However, univariately, the incidence of MetS during the 25-year follow-up did not differ by menarche timing group (63.6% vs. 49.1% vs. 46.0%, respectively, p=0.37). In multivariable Cox models, compared with the normal menarche group, women with early and delayed menarche had non-significantly higher (HR =1.42, p=0.26) and lower (HR =0.89, p=0.64) hazards of developing MetS, respectively. Duration of T1D, HbA1c, BMI and smoking history were significantly associated with a greater risk of MetS, whereas eGFR was significantly associated with a lower hazard of MetS.
In conclusion, unlike findings in the general population where early menarche increased the risk of MetS, in this cohort of women with T1D the incidence of MetS did not differ significantly by menarche timing group.
J. Ju: None. D. Rubinstein: None. S.R. El Khoudary: None. T.J. Orchard: None. T. Costacou: None.
National Institutes of Health (DK34818)