Early menarche is associated with an increased risk of type 2 diabetes in rural Chinese women and is partially mediated by BMI: the Henan Rural Cohort Study

Menopause. 2019 Nov;26(11):1265-1271. doi: 10.1097/GME.0000000000001385.


Objective: The aim of the study was to determine if early menarche is associated with an increased risk of type 2 diabetes mellitus (T2DM) in rural Chinese women and to estimate the proportion that can be attributed to adiposity.

Methods: A total of 15,346 postmenopausal women were enrolled in this study. Logistic regression and restricted cubic spline analysis were performed to estimate the relationship between age at menarche and T2DM. Mediation analysis was used to investigate whether the association was mediated by body mass index (BMI).

Results: After adjusting for multiple confounders, the early menarche group (≤14 y) had a higher risk of T2DM (odds ratio [OR] = 1.21; 95% CI = 1.06-1.38; P = 0.004) compared with the reference group (16-17 y), whereas the late onset group (≥19 y) had a lower risk of T2DM (OR = 0.78; 95% CI = 0.66-0.92; P = 0.003). BMI partially mediated the association between age at menarche and T2DM, and the proportion of the effect was 28%.

Conclusions: Early menarche increases the risk of T2DM, whereas later menarche decreases the risk. The association seems to be partially mediated by BMI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity
  • Age Factors*
  • Aged
  • Asian Continental Ancestry Group / statistics & numerical data
  • Body Mass Index*
  • China / epidemiology
  • Cohort Studies
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / etiology*
  • Female
  • Humans
  • Logistic Models
  • Menarche / physiology*
  • Middle Aged
  • Odds Ratio
  • Postmenopause
  • Proportional Hazards Models
  • Risk Factors
  • Rural Population / statistics & numerical data