Background: The association between age at menarche (AAM) and cardiovascular disease (CVD) has previously been investigated with controversial results. The relationship between the psychological characteristic of AAM and many cardiovascular risk factors remains unclear. Purpose: To assess the association between AAM and CVD risk factors in a large population. Design and Setting: 13,242 women aged 24-79 years were recruited from China mainland during 2009-2013 for a cross-sectional, population-based study to investigate the association between AAM and CVD risk factors. Information on AAM was obtained from self-report and information on CVD risk factors from physical examination. Results: In age-, body-mass-index- and height-adjusted analyses, AAM was positively associated with hypertension and ‘college or above' educational level and incident CVD events. The adjusted odds ratios (ORs) and 95% confidence intervals for hypertension across AAM categories (≤12, 13-14, 15-16, and ≥17 years) were 0.820 (0.70-0.96), 0.82 (0.70-0.96), 0.88 (0.79-0.99) and 1 (referent), respectively; adjusted ORs for high educational level (‘college or above') were 0.29 (0.24-0.34), 0.60 (0.41-0.51), 0.69 (0.62-0.76), and 1 (referent), respectively; adjusted ORs for incident CVD events were 0.18 (0.08-0.41), 0.18 (0.08-0.41), 0.62 (0.41-0.93), 1 (referent), respectively. Conclusions: Earlier AAM were positively associated with incident CVD events, hypertension and ‘college or above' educational level.

Keywords:
Age at menarche, Risk factors, Cardiovascular disease, Large population
1.
Jahanfar S, Lye MS, Krishnarajah IS: Genetic and environmental effects on age at menarche, and its relationship with reproductive health in twins. Indian J Hum Genet 2013;19:245-250.
2.
Rees M: The age of menarche. ORGYN 1995;4:2-4.
3.
Apter D, Vihko R: Early menarche, a risk factor for breast cancer, indicates early onset of ovulatory cycles. J Clin Endocrinol Metab 1983;57:82-86.
4.
Lujan Irastorza JE, Garcia Rodriguez F, Figueroa Preciado G, Hernandez Marin I, Ayala AR: Early menarche as a risk factor of breast cancer. Ginecol Obstet Mex 2006;74:568-572.
5.
Naves M, Diaz-Lopez JB, Gomez C, Rodriguez-Rebollar A, Cannata-Andia JB: Determinants of incidence of osteoporotic fractures in the female Spanish population older than 50. Osteoporos Int 2005;16:2013-2017.
6.
Macsali F, Real FG, Plana E, Sunyer J, Anto J, et al: Early age at menarche, lung function, and adult asthma. Am J Respir Crit Care Med 2011;183:8-14.
7.
Deecher D, Andree TH, Sloan D, Schechter LE: From menarche to menopause: exploring the underlying biology of depression in women experiencing hormonal changes. Psychoneuroendocrinology 2008;33:3-17.
8.
Patton GC, Hibbert ME, Carlin J, Shao Q, Rosier M, et al: Menarche and the onset of depression and anxiety in Victoria, Australia. J Epidemiol Community Health 1996;50:661-666.
9.
Bralic I, Tahirovic H, Matanic D, Vrdoljak O, Stojanovic-Spehar S, et al: Association of early menarche age and overweight/obesity. J Pediatr Endocrinol Metab 2012;25:57-62.
10.
He C, Zhang C, Hunter DJ, Hankinson SE, Buck Louis GM, et al: Age at menarche and risk of type 2 diabetes: results from 2 large prospective cohort studies. Am J Epidemiol 2010;171:334-344.
11.
Stockl D, Doring A, Peters A, Thorand B, Heier M, 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;55:681-688.
12.
Conway BN, Shu XO, Zhang X, Xiang YB, Cai H, et al: Age at menarche, the leg length to sitting height ratio, and risk of diabetes in middle-aged and elderly Chinese men and women. PLoS One 2012;7:e30625.
13.
Glueck CJ, Morrison JA, Wang P, Woo JG: Early and late menarche are associated with oligomenorrhea and predict metabolic syndrome 26 years later. Metabolism 2013;62:1597-1606.
14.
Stockl D, Meisinger C, Peters A, Thorand B, Huth C, 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:e26076.
15.
Qiu C, Chen H, Wen J, Zhu P, Lin F, et al: Associations between age at menarche and menopause with cardiovascular disease, diabetes, and osteoporosis in Chinese women. J Clin Endocrinol Metab 2013;98:1612-1621.
16.
Lakshman R, Forouhi NG, Sharp SJ, Luben R, Bingham SA, et al: Early age at menarche associated with cardiovascular disease and mortality. J Clin Endocrinol Metab 2009;94:4953-4960.
17.
Kivimaki M, Lawlor DA, Smith GD, Elovainio M, Jokela M, 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;87:1876-1882.
18.
Feng Y, Hong X, Wilker E, Li Z, Zhang W, et al: Effects of age at menarche, reproductive years, and menopause on metabolic risk factors for cardiovascular diseases. Atherosclerosis 2008;196:590-597.
19.
Remsberg KE, Demerath EW, Schubert CM, Chumlea WC, Sun SS, et al: Early menarche and the development of cardiovascular disease risk factors in adolescent girls: the Fels Longitudinal Study. J Clin Endocrinol Metab 2005;90:2718-2724.
20.
Mueller NT, Odegaard AO, Gross MD, Koh WP, Yuan JM, et al: Age at menarche and cardiovascular disease mortality in Singaporean Chinese women: the Singapore Chinese Health Study. Ann Epidemiol 2012;22:717-722.
21.
Canoy D, Boekholdt SM, Wareham N, Luben R, Welch A, et al: Body fat distribution and risk of coronary heart disease in men and women in the European Prospective Investigation Into Cancer and Nutrition in Norfolk cohort: a population-based prospective study. Circulation 2007;116:2933-2943.
22.
Cui R, Iso H, Toyoshima H, Date C, Yamamoto A, et al: Relationships of age at menarche and menopause, and reproductive year with mortality from cardiovascular disease in Japanese postmenopausal women: the JACC study. J Epidemiol 2006;16:177-184.
23.
Heys M, Schooling CM, Jiang C, Cowling BJ, Lao X, et al: Age of menarche and the metabolic syndrome in China. Epidemiology 2007;18:740-746.
24.
Jacobsen BK, Oda K, Knutsen SF, Fraser GE: Age at menarche, total mortality and mortality from ischaemic heart disease and stroke: the Adventist Health Study, 1976-1988. Int J Epidemiol 2009;38:245-252.
25.
Jacobsen BK, Heuch I, Kvale G: Association of low age at menarche with increased all-cause mortality: a 37-year follow-up of 61,319 Norwegian women. Am J Epidemiol 2007;166:1431-1437.
26.
Colditz GA, Willett WC, Stampfer MJ, Rosner B, Speizer FE, et al: A prospective study of age at menarche, parity, age at first birth, and coronary heart disease in women. Am J Epidemiol 1987;126:861-870.
27.
Bertuccio P, Tavani A, Gallus S, Negri E, La Vecchia C: Menstrual and reproductive factors and risk of non-fatal acute myocardial infarction in Italy. Eur J Obstet Gynecol Reprod Biol 2007;134:67-72.
28.
La Vecchia C, Decarli A, Franceschi S, Gentile A, Negri E, et al: Menstrual and reproductive factors and the risk of myocardial infarction in women under fifty-five years of age. Am J Obstet Gynecol 1987;157:1108-1112.
29.
de Kleijn MJ, van der Schouw YT, van der Graaf Y: Reproductive history and cardiovascular disease risk in postmenopausal women: a review of the literature. Maturitas 1999;33:7-36.
30.
Gupta R, Gupta VP, Ahluwalia NS: Educational status, coronary heart disease, and coronary risk factor prevalence in a rural population of India. BMJ 1994;309:1332-1336.
31.
Liu K, Cedres LB, Stamler J, Dyer A, Stamler R, et al: Relationship of education to major risk factors and death from coronary heart disease, cardiovascular diseases and all causes. Findings of three Chicago epidemiologic studies. Circulation 1982;66:1308-1314.
32.
Must A, Phillips SM, Naumova EN, Blum M, Harris S, et al: Recall of early menstrual history and menarcheal body size: after 30 years, how well do women remember? Am J Epidemiol 2002;155:672-679.
33.
Bosetti C, Tavani A, Negri E, Trichopoulos D, La Vecchia C: Reliability of data on medical conditions, menstrual and reproductive history provided by hospital controls. J Clin Epidemiol 2001;54:902-906.
34.
Mattsson N, Ronnemaa T, Juonala M, Viikari JS, Raitakari OT: Childhood predictors of the metabolic syndrome in adulthood. The Cardiovascular Risk in Young Finns Study. Ann Med 2008;40:542-552.
35.
Wong ND: Epidemiological studies of CHD and the evolution of preventive cardiology. Nat Rev Cardiol 2014;11:276-289.
36.
Herman-Giddens ME: The decline in the age of menarche in the United States: should we be concerned? J Adolesc Health 2007;40:201-203.
37.
Lawlor DA, Bedford C, Taylor M, Ebrahim S: Geographical variation in cardiovascular disease, risk factors, and their control in older women: British Women's Heart and Health Study. J Epidemiol Community Health 2003;57:134-140.
38.
Lemstra M, Rogers M, Moraros J: Income and heart disease: neglected risk factor. Can Fam Physician 2015;61:698-704.
39.
Yermachenko A, Dvornyk V: Nongenetic determinants of age at menarche: a systematic review. Biomed Res Int 2014;2014:371583.
40.
Donoso MA, Munoz-Calvo MT, Barrios V, Garrido G, Hawkins F, et al: Increased circulating adiponectin levels and decreased leptin/soluble leptin receptor ratio throughout puberty in female ballet dancers: association with body composition and the delay in puberty. Eur J Endocrinol 2010;162:905-911.
41.
Sun Y, Tao FB, Su PY, Mai JC, Shi HJ, et al: National estimates of the pubertal milestones among urban and rural Chinese girls. J Adolesc Health 2012;51:279-284.
42.
Parent AS, Teilmann G, Juul A, Skakkebaek NE, Toppari J, et al: The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev 2003;24:668-693.
43.
Kreatsoulas C, Anand SS: The impact of social determinants on cardiovascular disease. Can J Cardiol 2010;26:8c-13c.
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