Abstract
The objective was to examine the association between age at menarche and all-cause mortality. A population-based prospective study involving 55,128 Japanese women aged 40–79 years in 1988–1990 and followed up to December 2006 was used. A total of 6,967 deaths occurred during the follow-up. Hazard ratios (HR) and 95% confidence intervals (CI) adjusted for age, smoking and drinking status, exercise, sleeping hours, parity, menopausal status, and body mass index at baseline were calculated by Cox proportional hazards model. The HRs (95% CI) of all-cause mortality were 1.16 (1.01–1.32), 1.01 (0.92–1.11), 1.00, 0.97 (0.90–1.05), 0.98 (0.91–1.05), 0.92 (0.84–1.01), and 1.05 (0.96–1.14) for women with menarche aged 9–12, 13, 14 (referent), 15, 16, 17, 18–20 years, respectively, indicating an inverse J-shaped association (P for quadratic trend <.01). Moreover, women with menarche aged ≤12 years have a significantly high risk of all-cause mortality compared with those with menarche aged ≥13 years (HR 1.17, 95% CI 1.03–1.33). Comparing between women with menarche aged ≤13 years and ≥14 years, those with earlier age at menarche had borderline significantly high risk of all-cause mortality in both comparisons (HR 1.07, 95% CI 0.99–1.15, P = .082). Japanese women with early age at menarche of ≤12 years were associated with increased risk of all-cause mortality and those with late age at menarche of ≥18 years also had a slightly higher mortality risk. These associations were independent of lifestyle, anthropometric, and reproductive factors.
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Abbreviations
- 95% CI:
-
95% confidence interval
- BMI:
-
Body mass index
- CVD:
-
Cardiovascular disease
- HR:
-
Hazard ratio
- JACC:
-
Japan collaborative cohort study for evaluation of cancer risk
- RR:
-
Relative risk
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Acknowledgments
We wish to express our sincere appreciation to Drs. Kunio Aoki and Yoshiyuki Ohno, Professors Emeritus of the Nagoya University School of Medicine and former chairpersons of the JACC Study. We are also greatly indebted to Dr. Haruo Sugano, former Director of the Cancer Institute, Tokyo, who greatly contributed to the initiation of the JACC Study, Dr. Tomoyuki Kitagawa, Director Emeritus of the Cancer Institute of the Japanese Foundation for Cancer Research and former chairman of the Grant-in-Aid for Scientific Research on Priority Area ‘Cancer’ and to Dr. Kazao Tajima, Aichi Cancer Center and previous chairman of the Grant-in Aid for Scientific Research on Priority Area of Cancer Epidemiology, for their warm encouragement and support of this study.
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Member list of the JACC Study Group: The present members of the JACC Study Group who co-authored this paper together with their affiliations are as follows: Dr. Akiko Tamakoshi (present chairperson of the study group), Aichi Medical University School of Medicine; Drs. Mitsuru Mori & Fumio Sakauchi, Sapporo Medical University School of Medicine; Dr. Yutaka Motohashi, Akita University School of Medicine; Dr. Ichiro Tsuji, Tohoku University Graduate School of Medicine; Dr. Yosikazu Nakamura, Jichi Medical School; Dr. Hiroyasu Iso, Osaka University School of Medicine; Dr. Haruo Mikami, Chiba Cancer Center; Dr. Michiko Kurosawa, Juntendo University School of Medicine; Dr. Yoshiharu Hoshiyama, University of Human Arts and Sciences; Dr. Naohito Tanabe, Niigata University School of Medicine; Dr. Koji Tamakoshi, Nagoya University Graduate School of Health Science; Dr. Kenji Wakai, Nagoya University Graduate School of Medicine; Dr. Shinkan Tokudome, National Institute of Health and Nutrition; Dr. Koji Suzuki, Fujita Health University School of Health Sciences; Dr. Shuji Hashimoto, Fujita Health University School of Medicine; Dr. Shogo Kikuchi, Aichi Medical University School of Medicine; Dr. Yasuhiko Wada, Faculty of Human Life and Environmental Science, Kochi Women’s University; Dr. Takashi Kawamura, Kyoto University Center for Student Health; Dr. Yoshiyuki Watanabe, Kyoto Prefectural University of Medicine Graduate School of Medical Science; Dr. Kotaro Ozasa, Radiation Effects Research Foundation; Dr. Tsuneharu Miki, Kyoto Prefectural University of Medicine Graduate School of Medical Science; Dr. Chigusa Date, Faculty of Human Environmental Sciences, Nara Women’s University; Dr. Kiyomi Sakata, Iwate Medical University; Dr. Yoichi Kurozawa, Tottori University Faculty of Medicine; Dr. Takesumi Yoshimura, Fukuoka Institute of Health and Environmental Sciences; Dr. Yoshihisa Fujino, University of Occupational and Environmental Health; Dr. Akira Shibata, Kurume University School of Medicine; Dr. Naoyuki Okamoto, Kanagawa Cancer Center; and Dr. Hideo Shio, Moriyama Municipal Hospital.
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Tamakoshi, K., Yatsuya, H., Tamakoshi, A. et al. Early age at menarche associated with increased all-cause mortality. Eur J Epidemiol 26, 771–778 (2011). https://doi.org/10.1007/s10654-011-9623-0
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DOI: https://doi.org/10.1007/s10654-011-9623-0