Is there any association between age at menarche and anthropometric indices? A 15-year follow-up population-based cohort study

Age at menarche and risk of ovarian hyperstimulation syndrome in women undergoing IVF/ICSI cycles: a retrospective cohort study

OBJECTIVES

We aimed to explore the association between age at menarche (AAM) and ovarian hyperstimulation syndrome (OHSS) in fresh in vitro fertilisation (IVF)/intracytoplasmic sperm injection (ICSI) cycles.

DESIGN

A retrospective cohort study.

SETTING

Data were collected from a large obstetrics and gynaecology hospital in Sichuan, China.

PARTICIPANTS

This study included 17 419 eligible women aged ≤40 years who underwent the first IVF/ICSI cycles from January 2015 to December 2021. Women were divided into three groups according to their AAM: ≤12 years (n=5781), 13-14 years (n=9469) and ≥15 years (n=2169).

RESULTS

The means of age at recruitment and AAM were 30.4 years and 13.1 years, respectively. Restricted cubic spline models suggested that early menarche age increased the risk of OHSS. The multivariable logistic analysis showed that women with menarche age ≤12 years were more likely to suffer from OHSS (OR 1.321, 95% CI 1.113 to 1.567) compared with those aged 13-14 years among the whole cohort. This significant relationship remained in women administered with different ovarian stimulation protocols and gonadotrophin doses. When stratified by female age, this correlation was presented only in patients aged ≤30 years (OR 1.362, 95% CI 1.094 to 1.694). And the mediation analysis showed that the relationship between AAM and OHSS was totally mediated by antral follicle counts (AFC).

CONCLUSION

Menarche age earlier than 12 years may increase the OHSS risk in women aged ≤30 years through the mediation of AFC. More prospective studies are required to verify the results.

Separate and combined effects of famine exposure and menarche age on metabolic syndrome among the elderly: a cross-sectional study in China

BACKGROUND

Epidemiological studies have revealed multiple risk factors for metabolic syndrome. However, there are no consistent findings on the association between famine exposure, age at menarche, and the prevalence of metabolic syndrome. This cross-sectional study aimed to reveal the individual and combined effects of famine exposure and age at menarche on the prevalence of metabolic syndrome among elderly women.

METHODS

Four thousand seven hundred seventy participants between 60 and 93 years of age were selected from the China Health and Retirement Longitudinal Study. Statistical differences between the baseline characteristics of famine exposure, age at menarche, and metabolic syndrome were evaluated using the t-test, F-test, and Chi-square test. Three multivariable-adjusted logistic regression models were used to test the association between famine exposure, age of menarche, and the odds ratio of metabolic syndrome.

RESULTS

Two thousand one hundred ninety-eight (46.08%) participants had metabolic syndrome, while 2572 (53.92%) participants did not. Furthermore, 3068 (64.32%) women reported onset of menarche under 15 years of age, while 1702 (35.68%) women reported onset of menarche above 16 years of age. Regarding the separate association of famine exposure and age of menarche with metabolic syndrome, in model three, the adolescence/adulthood famine exposure group vs. no famine exposure group odds ratio was 2.45 (95% CI 2.02, 2.97), and the older than 16 years vs. younger than 15 years group odds ratio was 1.23 (95% CI 1.09, 1.39), which was the highest odds ratio among the three models. Regarding the combined association of famine exposure and age of menarche with metabolic syndrome, in model three, among the age of menarche ≤ 15 years group, the adolescence/adulthood famine exposure vs. no famine exposure group odds ratio was 2.45 (95% CI: 1.91, 3.14); among the menarche age ≥ 16 years group, the adolescence/adulthood famine exposure stages vs. exposed group odds ratio was 3.27 (95% CI: 2.44, 4.38), which was the highest odds ratio among the three models.

CONCLUSION

These findings suggested that famine exposure and age at menarche, either separately or in combination, were positively associated with the prevalence of metabolic syndrome among older women.

The association between early menarche and higher-risk cardiometabolic profile: a dose-response analysis of the Tabari cohort at enrollment phase

Objectives

The association between age at menarche and higher-risk cardiometabolic factors is controversial and more strands of evidence are required. Therefore, in this study, we aimed to investigate the effect of early menarche on cardiometabolic profile in a large-scale cohort population.

Study design

Data collected in the enrollment phase of the Tabari cohort study were utilized for the present study. We analyzed data from 6,103 women aged 35-70 years. Logistic regression and dose-response (trend) analyses were used to investigate the effect of early menarche on prevalence of diabetes, dyslipidemia, obesity, high waist circumference (WC), high waist-to-hip ratio (WHR), and high waist-to-height ratio (WHtR).

Results

The results of the adjusted logistic regression analysis showed that women who experienced early menarche had significantly higher odds of obesity (odds ratio: 1.64, 95% CI: 1.36-1.99, P for trend <0.001), high WC (odds ratio: 1.34, 95% CI: 1.07-1.67, P for trend = 0.035), high WHR (odds ratio: 1.32, 95% CI: 1.05-1.66, P for trend = 0.057), and high WHtR (odds ratio: 1.83, 95% CI: 1.22-2.74, P for trend = 0.006) compared to those aged ≥14 at menarche. The prevalence of dyslipidemia was also higher among women who experienced early menarche than in women aged ≥14 at menarche (79.9% vs. 76.6%), but the difference was not statistically significant (P = 0.098). Additionally, each year of earlier menarche was significantly associated with an increase in the chance of diabetes (by 5%), obesity (10%), high WC (5%), and high WHtR (13%).

Conclusion

The present study showed that early menarche is a strong predictor for later development of obesity and diabetes, and for high WC, WHR, and WHtR. Among all factors examined, age at menarche had the greatest predictive power for WHtR. As an age-dependent anthropometric index for central obesity, WHtR is more suitable as an index for identification of individuals with increased cardiometabolic risk.

Is early age at menarche associated with multimorbidity? Findings from the Azar Cohort study

AIMS

This study aimed to assess the association of age at menarche (AAM) with multimorbidity and chronic diseases.

METHODS

We used data regarding the reproductive history of 8,294 female participants of the Azar Cohort Study. A questionnaire assessed the participants' demographic information, reproductive history, personal behaviors, smoking status, socioeconomic status, activity status, and wealth score index.

RESULTS

Among 8,286 women included in the analysis, the AAM was < 12 years (early) in 648 (7.8%), 12-14 years (normal) in 4,911 (59.3%), and > 14 years (late) in 2,727 (32.9%) individuals. Early menarche was associated with a high risk of diabetes, obesity, and high WHR. On the other hand, late menarche was associated with higher rates of hypertension, stroke, and diabetes but a lower risk of MM, rheumatoid disease, obesity, abdominal obesity, and WHtR.

CONCLUSION

Changes in AAM have significant health implications. Factors predisposing individuals to early menarche and its consequences should be considered in chronic disease prevention strategies for adolescents and young adults.

The association between arterial hypertension and menarcheal age

OBJECTIVE

Menarche, as a milestone of puberty, may have a long-term effect on health. The present study investigated the association of age at menarche with the incidence of arterial hypertension.

STUDY DESIGN

A total of 4747 post-menarcheal participants of the Tehran Lipid and Glucose Study who met the eligibility criteria were selected. Demographic, lifestyle, reproductive, and anthropometric data, as well as risk factors for cardiovascular diseases, were collected. Participants were classified according to their age at menarche: group I: ≤11 years, group II: 12-15 years, and group III: ≥16 years.

MAIN OUTCOME MEASURES

A Cox proportional hazards regression model was used to estimate the associations between age at menarche and arterial hypertension outcomes. The generalized estimating equation models were used to compare the trend of changes in systolic and diastolic blood pressure between the three groups.

RESULTS

The mean age of participants at baseline was 33.9 (13.0). At the end of the study, 1261 (26.6 %) participants had arterial hypertension. Women in group III had a 2.04-fold higher risk of arterial hypertension than those in group II. The mean changes in systolic and diastolic blood pressure were 29 % (95 % CI: 0.02-0.57) and 16 % (95 % CI: 0.00-0.38) higher for women in group III compared with group II.

CONCLUSIONS

Late menarche could be a risk factor for arterial hypertension, so it is necessary to pay more attention to age at menarche in cardiovascular risk assessment programs.

Factors Affecting Menstrual Cycle Developmental Trajectory in Adolescents: A Narrative Review

CONTEXT

The time interval between the age at menarche and regulation of menstrual cycles (menstrual cycle developmental trajectory) is considered an indicator of the function of the reproductive system later in life. This study aimed to summarize the factors affecting this trajectory.

EVIDENCE ACQUISITION

A comprehensive literature search in PubMed, Scopus, Google Scholar, and Web of Science was performed to identify studies investigating factors influencing the regularity of the menstrual cycle in adolescents.

RESULTS

The interval between menarche and the onset of the regular menstrual cycle in adolescent girls may vary from several months to several years. Several factors, including genetic, race/ethnicity, intrauterine situation, social factors, geographical factors, lifestyle, and chronic diseases, are considered the predisposing factors for the trajectory.

CONCLUSIONS

Age at menarche and the onset of regular menstrual cycles are directly and indirectly influenced by several genetic, environmental, and lifestyle factors. Understanding these factors may improve our practice in managing irregular menstrual cycles that commonly happen in the first years after menarche.

A secular trend in age at menarche in Yunnan Province, China: a multiethnic population study of 1,275,000 women

Background

Age at menarche (AAM) has shown different trends in women from different ethnic and economic regions in recent decades. Data on AAM among multiethnic women living in developing areas are scarce.

Methods

Data on AAM from 1,275,000 women among 26 ethnicities in Yunnan Province, China, who were born from 1965 to 2001 were obtained from the National Free Preconception Health Examination Project from 2010 to 2018. The patterns of AAM trends were analysed according to ethnic group, area of residence, and socioeconomic status.

Results

The mean AAM was 13.7 ± 1.21 years (95% CI 13.697–13.701), with a decrease from 14.12 (±1.41) among women born before 1970 to 13.3 (±1.04) among those born after 2000. The decline was 0.36 years per 10-year birth cohort, and the plateau has not yet been reached in Yunnan. A secular trend of earlier AAM was observed in all 26 ethnic groups. The fastest rate of decline was observed for the Bai ethnicity (0.36 years per decade). Consistent declining trends in AAM appeared among extreme-, middling-, and nonpoverty economic patterns from 1965 to 2001, with reductions of 1.19, 1.44, and 1.5 years, respectively (P < 0.001). The peak reduction among middling poverty and extreme poverty occurred in the early 2000s (0.4 and 0.32 years). Multivariate analysis showed a significant difference in the declining trends in AAM along rural/urban lines (P < 0.001).

Conclusion

There was a secular trend towards a younger AAM during the twentieth century and early twenty-first century birth cohorts in the Yunnan population. Considering the difference in AAM trends due to ethnic and socioeconomic status in Yunnan, the health authority should utilize flexible adjusted health care strategies in different regions.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11951-x.

The influence of socioeconomic status on menarcheal age among Chinese school-age girls in Tianjin, China

The association between socioeconomic status and the onset age of menarche is still not conclusive. This cross-sectional study was conducted among primary and middle school girls aged 7 to 16 years old in Tianjin, China, to explore the distribution of menarcheal age and its association with socioeconomic status. A self-designed structured questionnaire was completed by students and their parents to collect information on socioeconomic status (i.e., family income, parental education level, living residence), menarcheal status, and covariates (weight status of girls and their parents, sleeping hours per day, physical activity). Information on menarcheal status included whether or not menarche had occurred (Yes/No) and the exact age at menarche. Linear regression analysis was used to explore the association between socioeconomic status and menarcheal age before and after covariate adjustment. Among 1485 eligible girls with complete information, 445 had experienced menarche, with an overall menarche rate of 30%. The mean age at menarche was 12.9 years (95% confidence interval 12.8-13.0). Urban girls experienced menarche earlier than rural girls did (12.1 years vs. 13.5 years). Univariate analysis showed that urban residence and higher parental education were associated with earlier onset of menarche. After covariate adjustment, the significance still existed. However, after adjusting further for residence, the significant association with the parental education disappeared. Only urban residence was still significantly associated, even after further adjustment for parental education and family income, with adjusted regression coefficients (95% confidence interval) of - 1.087 (- 1.340,-0.834), indicating that the onset age of menarche among urban girls was 1.087 years (0.834, 1.340) younger than that among rural girls. Family income was not related to the onset age of menarche in any analyses.Conclusion: Urban-rural differences played a more important role in the early onset of menarche than socioeconomic differences between families. What is Known: • The age at menarche varies by race and country, but the global trend is towards earlier onset as a result of changes in nutrition, family structure, socioeconomic status, and physical condition. What is New: • Urban girls experienced menarche earlier than rural girls, but this urban-rural difference could not be explained by family income, parental education, weight status of the participants and their parents, participants' physical exercise and sleeping hours. • Higher parental education was associated with earlier onset of menarche, but this association disappeared after adjustment for living residence.

Growth and socio-economic status, influence on the age at menarche in school going girls

INTRODUCTION

Onset age at menarche has been considered an important indicator of reproductive maturity in females and reflects the health status of the population. The purpose of this study was to determine the mean menarcheal age and to examine whether anthropometric and socio-economic status (SES) influences age at menarche in the girls from Punjab province of Pakistan.

METHODS

In this population-based cross-sectional study, 10,050 school-going girls aged 8-16 years from 35 schools across 12 districts of Punjab were recruited. Menarcheal data was obtained by using a questionnaire, while the anthropometric data were obtained by the measurements of standing height, body weight, waist, and hip circumference. The anthropometric indices of pre- and post-menarcheal girls were compared. Student's t-test, ANOVA, and post-hoc Tukey's test was applied for comparison between two and multiple groups respectively, P < 0.05 was considered statistically significant.

RESULTS

There was a normal distribution of age at menarche and mean was 12.4 years in the study population. The girls who reached menarche were found to be taller and heavier with higher BMIs, having a greater waist and hip circumference as compared to their pre-menarcheal peers. Waist-hip-ratio was less, and the waist-to-height ratio was higher in post-menarcheal as compared to pre-menarcheal girls. The girls belonging to low SES had delayed onset of menarche as compared to those belonging to middle/high SES.

CONCLUSION

The age at menarche was associated with SES and changes in various anthropometric measurements reflecting the growth status of girls.

Adolescent Sport Participation and Age at Menarche in Relation to Midlife Body Composition, Bone Mineral Density, Fitness, and Physical Activity

This study aimed to investigate the associations of competitive sport participation in adolescence and age at menarche (AAM) with body composition, femoral neck bone mineral density (BMD), physical performance, and physical activity (PA) in middle-aged women. 1098 women aged 47–55 years formed the sample of this retrospective study. Participants self-reported their PA level at age 13–16 years and AAM. The protocol also included dual-energy X-ray absorptiometry, physical performance tests, and accelerometer-measured PA. Participants were divided into three groups according to their PA level at the age of 13–16 (no exercise, regular PA, and competitive sport) and according to their AAM (≤12, 13, and ≥14 years). After adjusting for potential confounding factors, participation in competitive sport at age 13–16 was associated with higher midlife lean mass and BMD, and better physical performance compared to groups with no exercise or regular PA. Individuals with AAM ≥ 14 years had lower midlife BMI and fat mass than participants in the other AAM groups and pre- and perimenopausal women with AAM ≥ 14 years had lower BMD than those with AAM ≤ 12. The findings indicate that participation in competitive sport in adolescence is associated with healthier body composition, higher BMD, and better physical performance in midlife, but BMD might be impaired if menarche occurs late.