Based on the fact that obesity is associated with early menarche and given the well-recognized relationship between obesity and diabetes incidence, Lakshman et al. hypothesized that early menarche was associated with diabetes incidence. For this purpose, they followed 13,308 women enrolled in the EPIC-Norfolk population study for about 10 years during which time 734 incident diabetes cases were reported. The study’s main finding was that women in the oldest quintile of age at menarche (15-18 years compared to the bottom quintile of 8-11 years) had a reduced risk of diabetes (hazard ratio=0.66; 95% CI, 0.51-0.86) after adjusting for age, family history of diabetes, physical activity levels, smoking, occupational social class, parity, and use of hormonal preparations. The protective effect of age at menarche was lost upon adjusting for obesity estimates such as body mass index or waist circumference, suggesting that adiposity might largely explain the relationship between age at menarche and diabetes risk. The authors of the study concluded that earlier age at menarche could help identify those at increased diabetes risk.
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