Abstract
A combination of genetic and environmental factors determines age of menarche. In Korea, there has been a trend for a younger age of menarche as the country has undergone industrialization and adopted a westernized diet. Previous studies have indicated that the incidence of obesity and metabolic syndrome, as well as cardiovascular mortality, is higher in women who undergo menarche at a younger age. This study was conducted to examine the relationship between age of menarche and metabolic syndrome in premenopausal women in Korea. Data for 1464 women were collected from the Sixth Korea National Health and Nutrition Examination Survey (KNHANES VI). The modified NCEP-ATP III criteria were used to define metabolic syndrome. Considering the unit of data extraction (investigation district), stratification variables, and weighted value, a complex sample design extraction method was applied for statistical analysis. After dividing the subjects by age of menarche, the risk of metabolic syndrome was assessed using multiple logistic regression analysis adjusting for age, smoking, drinking, exercise, education level, household income, and marital status. When the subjects were grouped by age of menarche (<12, 12–13, 14–15, and >16 years), a statistically significant increase in the average age of the group was observed (23.8 ± 0.8, 29.6 ± 0.4, 35.8 ± 0.4, and 39.8 ± 0.7, respectively; p < 0.001). The adjusted odds ratio (95 % CI) for metabolic syndrome was 3.84 (1.52–9.70) in women who reached menarche at <12 years compared to those who reached menarche at >16 years. Age of menarche is associated with the risk of metabolic syndrome in premenopausal women in Korea.
Similar content being viewed by others
References
Shalitin S, Phillip M. Role of obesity and leptin in the pubertal process and pubertal growth—a review. Int J Obes Related Metab Disord: J Int Assoc Study of Obes. 2003;27(8):869–74. doi:10.1038/sj.ijo.0802328.
Karapanou O, Papadimitriou A. Determinants of menarche. Reprod Biol Endocrinol: RB E. 2010;8:115. doi:10.1186/1477-7827-8-115.
Dunger DB, Ahmed ML, Ong KK. Effects of obesity on growth and puberty. Best Pract Res Clin Endocrinol Metab. 2005;19(3):375–90. doi:10.1016/j.beem.2005.04.005.
Cho GJ, Park HT, Shin JH, Hur JY, Kim YT, Kim SH, et al. Age at menarche in a Korean population: secular trends and influencing factors. Eur J Pediatr. 2010;169(1):89–94. doi:10.1007/s00431-009-0993-1.
Kim JY, Oh IH, Lee EY, Oh CM, Choi KS, Choe BK, et al. The relation of menarcheal age to anthropometric profiles in Korean girls. J Korean Med Sci. 2010;25(10):1405–10. doi:10.3346/jkms.2010.25.10.1405.
Dreyfus J, Jacobs Jr DR, Mueller N, Schreiner PJ, Moran A, Carnethon MR, et al. Age at menarche and cardiometabolic risk in adulthood: the coronary artery risk development in young adults study. J Pediatr. 2015. doi:10.1016/j.jpeds.2015.04.032.
Stockl D, Meisinger C, Peters A, Thorand B, Huth C, Heier M, et al. Age at menarche and its association with the metabolic syndrome and its components: results from the KORA F4 study. PLoS ONE. 2011;6(10):e26076. doi:10.1371/journal.pone.0026076.
Stockl D, Doring A, Peters A, Thorand B, Heier M, Huth C, et al. Age at menarche is associated with prediabetes and diabetes in women (aged 32-81 years) from the general population: the KORA F4 Study. Diabetologia. 2012;55(3):681–8. doi:10.1007/s00125-011-2410-3.
Kivimaki M, Lawlor DA, Smith GD, Elovainio M, Jokela M, Keltikangas-Jarvinen L, et al. Association of age at menarche with cardiovascular risk factors, vascular structure, and function in adulthood: the Cardiovascular Risk in Young Finns study. Am J Clin Nutr. 2008;87(6):1876–82.
Mueller NT, Duncan BB, Barreto SM, Chor D, Bessel M, Aquino EM, et al. Earlier age at menarche is associated with higher diabetes risk and cardiometabolic disease risk factors in Brazilian adults: Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Cardiovasc Diabetol. 2014;13:22. doi:10.1186/1475-2840-13-22.
Akter S, Jesmin S, Islam M, Sultana SN, Okazaki O, Hiroe M, et al. Association of age at menarche with metabolic syndrome and its components in rural Bangladeshi women. Nutr Metabol. 2012;9(1):99. doi:10.1186/1743-7075-9-99.
Al-Awadhi N, Al-Kandari N, Al-Hasan T, Almurjan D, Ali S, Al-Taiar A. Age at menarche and its relationship to body mass index among adolescent girls in Kuwait. BMC Public Health. 2013;13:29. doi:10.1186/1471-2458-13-29.
Lim JS, Lee HS, Kim EY, Yi KH, Hwang JS. Early menarche increases the risk of type 2 diabetes in young and middle-aged Korean women. Diabet Med: J British Diabet Assoc. 2015;32(4):521–5. doi:10.1111/dme.12653.
Mozumdar A, Liguori G. Persistent increase of prevalence of metabolic syndrome among U.S. adults: NHANES III to NHANES 1999-2006. Diabetes Care. 2011;34(1):216–9. doi:10.2337/dc10-0879.
Alberti KG, Zimmet P, Shaw J. The metabolic syndrome—a new worldwide definition. Lancet (London, England). 2005;366(9491):1059–62. doi:10.1016/s0140-6736(05)67402-8.
Lim S, Shin H, Song JH, Kwak SH, Kang SM, Won Yoon J, et al. Increasing prevalence of metabolic syndrome in Korea: the Korean National Health and Nutrition Examination Survey for 1998-2007. Diabetes Care. 2011;34(6):1323–8. doi:10.2337/dc10-2109.
Heys M, Schooling CM, Jiang C, Cowling BJ, Lao X, Zhang W, et al. Age of menarche and the metabolic syndrome in China. Epidemiology (Cambridge, Mass). 2007;18(6):740–6. doi:10.1097/EDE.0b013e3181567faf.
Cho GJ, Park HT, Shin JH, Kim T, Hur JY, Kim YT, et al. The relationship between reproductive factors and metabolic syndrome in Korean postmenopausal women: Korea National Health and Nutrition Survey 2005. Menopause (New York, NY). 2009;16(5):998–1003. doi:10.1097/gme.0b013e3181a03807.
Charalampopoulos D, McLoughlin A, Elks CE, Ong KK. Age at menarche and risks of all-cause and cardiovascular death: a systematic review and meta-analysis. Am J Epidemiol. 2014;180(1):29–40. doi:10.1093/aje/kwu113.
Elks CE, Perry JR, Sulem P, Chasman DI, Franceschini N, He C, et al. Thirty new loci for age at menarche identified by a meta-analysis of genome-wide association studies. Nat Genet. 2010;42(12):1077–85. doi:10.1038/ng.714.
Perry JR, Stolk L, Franceschini N, Lunetta KL, Zhai G, McArdle PF, et al. Meta-analysis of genome-wide association data identifies two loci influencing age at menarche. Nat Genet. 2009;41(6):648–50. doi:10.1038/ng.386.
Ku SY, Kang JW, Kim H, Kim YD, Jee BC, Suh CS, et al. Age at menarche and its influencing factors in North Korean female refugees. Hum Reprod. 2006;21(3):833–6. doi:10.1093/humrep/dei271.
Biro FM, Wien M. Childhood obesity and adult morbidities. The American journal of Clinical Nutrition. 2010;91(5):1499s–505s. doi:10.3945/ajcn.2010.28701B.
Vryonidou A, Paschou SA, Muscogiuri G, Orio F, Goulis D. Mechanisms in endocrinology: metabolic syndrome through the female life cycle. Eur J Endocrinol/Eur Federat Endocr Soc. 2015. doi:10.1530/eje-15-0275.
Alonso de Lecinana M, Egido JA, Fernandez C, Martinez-Vila E, Santos S, Morales A, et al. Risk of ischemic stroke and lifetime estrogen exposure. Neurology. 2007;68(1):33–8. doi:10.1212/01.wnl.0000250238.69938.f5.
Meirelles RM. Menopause and metabolic syndrome. Arquivos brasileiros de endocrinologia e metabologia. 2014;58(2):91–6.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
The details of this study and the KNHANES methodology have been approved by the Institutional Review Board of the Korea Centers for Disease Control and Prevention and with the 1964 Helsinki declaration and its later amendments.
Conflict of interests
The authors declare that they have no competing interests.
Rights and permissions
About this article
Cite this article
Cho, Y.J., Lee, G.H. Association of age at menarche with metabolic syndrome and components of metabolic syndrome in premenopausal women, Korea National Health and nutrition examination survey VI. Int J Diabetes Dev Ctries 36, 345–351 (2016). https://doi.org/10.1007/s13410-016-0488-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13410-016-0488-3