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Open Access 18-03-2024 | Obesity | Original Article

Early age at menarche and the risk of gestational diabetes mellitus: a cohort study

Authors: Anastasia Angelopoulou, Kleoniki I. Athanasiadou, Maria Zairi, Evangelia Zapanti, Vasiliki Vasileiou, Stavroula A. Paschou, Eleni Anastasiou

Published in: Endocrine

Abstract

Purpose

To evaluate whether there is an association between age at menarche (AAM) and the risk of gestational diabetes mellitus (GDM).

Methods

A retrospective cohort study was conducted, including 5390 pregnant women who were screened for GDM at Alexandra Hospital in Athens, Greece over a 15-year period (2000–2014). Maternal age, pre-pregnancy body mass index (BMI), height, family history of type 2 diabetes mellitus, parity, educational and smoking status, and AAM were recorded. The results were expressed as odds ratios (OR) with a 95% confidence interval (95% CI).

Results

Pregnant women with GDM experienced earlier menarche compared to normoglycemic women (12.9 ± 1.5 vs 13.1 ± 1.6, p < 0.001, respectively). The OR for a woman with AAM <12 years to develop GDM was 1.08 (95% CI 1.03–1.14), while the OR to be obese was 1.70 (95% CI 1.50–1.90). The multivariate logistic regression analysis showed that AAM is a risk factor for GDM. However, that effect was lost after adjusting for BMI.

Conclusion

Early AAM may be associated with an increased risk of GDM. Therefore, it can be used to identify high-risk women and implement preconception interventions for GDM prevention. Future studies should be conducted to confirm these findings.

H. Wang, N. Li, T. Chivese, M. Werfalli, H. Sun, L. Yuen et al. IDF diabetes atlas: estimation of global and regional gestational diabetes mellitus prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group’s Criteria. Diabetes Res. Clin. Pract. 183, 109050 (2022). https://doi.org/10.1016/j.diabres.2021.109050CrossRefPubMed

E. Anastasiou, G. Farmakidis, A. Gerede, D.G. Goulis, E. Koukkou, A. Kourtis et al. Clinical practice guidelines on diabetes mellitus and pregnancy: ΙI. Gestational diabetes mellitus. Hormones 19, 601–607 (2020). https://doi.org/10.1007/s42000-020-00193-yCrossRefPubMed

S.A. Paschou, E. Bletsa, M. Papazisi, N. Mili, F. Kanouta, G.N. Kassi, et al. Screening and management of major endocrinopathies during pregnancy: an update. Endocrine 10–19 (2022). https://doi.org/10.1007/s12020-022-03237-y.

D. Eleftheriou, K.I. Athanasiadou, E. Sifnaios, E. Vagiakis, P. Katsaounou, T. Psaltopoulou, et al. Sleep disorders during pregnancy: an underestimated risk factor for gestational diabetes mellitus. Endocrine (2023). https://doi.org/10.1007/s12020-023-03537-x.

K.I. Athanasiadou, S.A. Paschou, E. Papakonstantinou, V. Vasileiou, F. Kanouta, P. Kazakou, et al. Smoking during pregnancy and gestational diabetes mellitus: a systematic review and meta-analysis. Endocrine (2023). https://doi.org/10.1007/s12020-023-03423-6.

P. Konstantakou, S.A. Paschou, I. Patinioti, E. Vogiatzi, V. Sarantopoulou, E. Anastasiou, The effect of smoking on the risk of gestational diabetes mellitus and the OGTT profile during pregnancy. Diabetes Res. Clin. Pract. 158, 107901 (2019). https://doi.org/10.1016/j.diabres.2019.107901CrossRefPubMed

V. Vasileiou, E. Kyratzoglou, S.A. Paschou, M. Kyprianou, E. Anastasiou, The impact of environmental temperature on the diagnosis of gestational diabetes mellitus. Eur. J. Endocrinol. 178, 209–214 (2018). https://doi.org/10.1530/EJE-17-0730CrossRefPubMed

I. Culpin, J. Heron, R. Araya, R. Melotti, G. Lewis, C. Joinson, Father absence and timing of menarche in adolescent girls from a UK cohort: The mediating role of maternal depression and major financial problems. J. Adolesc. 37, 291–301 (2014). https://doi.org/10.1016/j.adolescence.2014.02.003CrossRefPubMed

J.R. Roy, S. Chakraborty, T.R. Chakraborty, Estrogen-like endocrine disrupting chemicals affecting puberty in humans - a review. Med. Sci. Monit. 15, 137–145 (2009).

10.

K.L. Land, F.G. Miller, A.C. Fugate, P.R. Hannon, The effects of endocrine-disrupting chemicals on ovarian- and ovulation-related fertility outcomes. Mol. Reprod. Dev. 89, 608–631 (2022). https://doi.org/10.1002/mrd.23652CrossRefPubMedPubMedCentral

11.

N.T. Mueller, B.B. Duncan, S.M. Barreto, D. Chor, M. Bessel, E.M.L. Aquino 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. 13, 1–8 (2014). https://doi.org/10.1186/1475-2840-13-22CrossRef

12.

M. Amstalden, B.R.C. Alves, S. Liu, R.C. Cardoso, G.L. Williams, Neuroendocrine pathways mediating nutritional acceleration of puberty: Insights from ruminant models. Front. Endocrinol. 2, 1–7 (2011). https://doi.org/10.3389/fendo.2011.00109CrossRef

13.

C. He, C. Zhang, D.J. Hunter, S.E. Hankinson, G.M. Buck Louis, M.L. Hediger et al. Age at menarche and risk of type 2 diabetes: Results from 2 large prospective cohort studies. Am. J. Epidemiol. 171, 334–344 (2010). https://doi.org/10.1093/aje/kwp372CrossRefPubMed

14.

O. Karapanou, A. Papadimitriou, Determinants of menarche. Reprod. Biol. Endocrinol. 8, 1–8 (2010). https://doi.org/10.1186/1477-7827-8-115CrossRef

15.

Y. Ren, H. Zou, D. Zhang, C. Han, D. Hu, Relationship between age at menarche and risk of glucose metabolism disorder: a systematic review and dose-response meta-analysis. Menopause 27, 818–826 (2020). https://doi.org/10.1097/GME.0000000000001529CrossRefPubMed

16.

X. Sun, L. Yang, J. Pan, H. Yang, Y. Wu, Z. Chen et al. Age at menarche and the risk of gestational diabetes mellitus: a systematic review and meta-analysis. Endocrine 61, 204–209 (2018). https://doi.org/10.1007/s12020-018-1581-9CrossRefPubMed

17.

M. Dishi, D.A. Enquobahrie, D.F. Abetew, C. Qiu, C.B. Rudra, M.A. Williams, Age at menarche, menstrual cycle characteristics and risk of gestational diabetes. Diabetes Res. Clin. Pract. 93, 437–442 (2011). https://doi.org/10.1016/j.diabres.2011.07.001CrossRefPubMed

18.

L. Chen, S. Li, C. He, Y. Zhu, G.M. Buck Louis, E. Yeung et al. Age at menarche and risk of gestational diabetes mellitus: a prospective cohort study among 27,482 women. Diabetes Care 39, 469–471 (2016). https://doi.org/10.2337/dc15-2011CrossRefPubMedPubMedCentral

19.

Y. Shen, H. Hu, B. D. Taylor, H. Kan, X. Xu, Early menarche and gestational diabetes mellitus at first live birth. Matern. Child Health J. 21, 593–598 (2017). https://doi.org/10.1007/s10995-016-2143-5CrossRefPubMed

20.

D.A.J.M. Schoenaker, G.D. Mishra, Association between age at menarche and gestational diabetes mellitus the Australian longitudinal study on women’s health. Am. J. Epidemiol. 185, 554–561 (2017). https://doi.org/10.1093/aje/kww201CrossRefPubMed

21.

D.H. Morris, M.E. Jones, M.J. Schoemaker, A. Ashworth, A.J. Swerdlow, Familial concordance for age at menarche: analyses from the Breakthrough Generations study. Paediatr. Perinat. Epidemiol. 25, 306–311 (2011). https://doi.org/10.1111/j.1365-3016.2010.01183.xCrossRefPubMed

22.

H. Li, L. Shen, L. Song, B. Liu, X. Zheng, S. Xu et al. Early age at menarche and gestational diabetes mellitus risk: results from the Healthy Baby Cohort study. Diabetes Metab. 43, 248–252 (2017). https://doi.org/10.1016/j.diabet.2017.01.002CrossRefPubMed

23.

M.M. Hedderson, F. Xu, J.A. Darbinian, C.P. Quesenberry, S. Sridhar, C. Kim et al. Prepregnancy SHBG concentrations and risk for subsequently developing gestational diabetes mellitus. Diabetes Care 37, 1296–1303 (2014). https://doi.org/10.2337/dc13-1965CrossRefPubMedPubMedCentral

24.

L. Wang, B. Yan, X. Shi, H. Song, W. Su, B. Huang et al. Age at menarche and risk of gestational diabetes mellitus: a population-based study in Xiamen, China. BMC Pregnancy Childbirth 19, 1–7 (2019). https://doi.org/10.1186/s12884-019-2287-6CrossRef

25.

A. Ergin, Ü. Türkay, S. Özdemir, A. Taşkın, H. Terzi, M. Özsürmeli, Age at menarche: risk factor for gestational diabetes. J. Obstet. Gynaecol. 42, 680–686 (2022). https://doi.org/10.1080/01443615.2021.1929116CrossRefPubMed

26.

L. Lu, B. Wan, M. Sun, Mendelian randomization identifies age at menarche as an independent causal effect factor for gestational diabetes mellitus. Diabetes Obes. Metab. 25, 248–260 (2023). https://doi.org/10.1111/dom.14869CrossRefPubMed

27.

D.S. Freedman, L. Kettel Khan, M.K. Serdula, W.H. Dietz, S.R. Srinivasan, G.S. Berenson, The relation of menarcheal age to obesity in childhood and adulthood: the Bogalusa Heart study. BMC Pediatr. 3, 1–9 (2003). https://doi.org/10.1186/1471-2431-3-3CrossRef

28.

S. Ramachandran, G.I. Hackett, R.C. Strange, Sex hormone binding globulin: a review of its interactions with testosterone and age, and its impact on mortality in men with type 2 diabetes. Sex. Med. Rev. 7, 669–678 (2019). https://doi.org/10.1016/j.sxmr.2019.06.006CrossRefPubMed

29.

D. Apter, M. Reinilä, R. Vihko, Some endocrine characteristics of early menarche, a risk factor for breast cancer, are preserved into adulthood. Int. J. Cancer 44, 783–787 (1989). https://doi.org/10.1002/ijc.2910440506CrossRefPubMed

30.

M.A. Tawfeek, E.M. Alfadhli, A.M. Alayoubi, H.A. El-Beshbishy, F.A. Habib, Sex hormone binding globulin as a valuable biochemical marker in predicting gestational diabetes mellitus. BMC Womens Health 17, 3–7 (2017). https://doi.org/10.1186/s12905-017-0373-3CrossRef

31.

A. Thankamony, K.K. Ong, M.L. Ahmed, A.R. Ness, J.M.P. Holly, D.B. Dunger, Higher levels of IGF-I and adrenal androgens at age 8 years are associated with earlier age at menarche in girls. J. Clin. Endocrinol. Metab. 97, 786–790 (2012). https://doi.org/10.1210/jc.2011-3261CrossRef

32.

E.L. Ding, Y. Song, V.S. Malik, S. Liu, Sex differences of endogenous sex hormones and risk of type 2 diabetes. Jama 295, 1288 (2006). https://doi.org/10.1001/jama.295.11.1288CrossRefPubMed

33.

M. Sawada, H. Masuyama, K. Hayata, Y. Kamada, K. Nakamura, Y. Hiramatsu, Pregnancy complications and glucose intolerance in women with polycystic ovary syndrome. Endocr. J. 62, 1017–1023 (2015). https://doi.org/10.1507/endocrj.EJ15-0364CrossRefPubMed

34.

R.V. Considine, M.K. Sinha, M.L. Heiman, A. Kriauciunas, T.W. Stephens, M.R. Nyce et al. Serum immunoreactive-leptin concentrations in normal-weight and obese humans. N. Engl. J. Med. 334, 292–295 (1996). https://doi.org/10.1056/NEJM199602013340503CrossRefPubMed

35.

J.H. Quennell, A.C. Mulligan, A. Tups, X. Liu, S.J. Phipps, C.J. Kemp et al. Leptin indirectly regulates gonadotropin-releasing hormone neuronal function. Endocrinology 150, 2805–2812 (2009). https://doi.org/10.1210/en.2008-1693CrossRefPubMedPubMedCentral

36.

V. Matkovic, J.Z. Ilich, M. Skugor, N.E. Badenhop, P. Goel, A. Clairmont et al. Leptin is inversely related to age at menarche in human females. J. Clin. Endocrinol. Metab. 82, 3239–3245 (1997). https://doi.org/10.1210/jc.82.10.3239CrossRefPubMed

Title: Early age at menarche and the risk of gestational diabetes mellitus: a cohort study
Authors: Anastasia Angelopoulou
Kleoniki I. Athanasiadou
Maria Zairi
Evangelia Zapanti
Vasiliki Vasileiou
Stavroula A. Paschou
Eleni Anastasiou
Publication date: 18-03-2024
Publisher: Springer US
Keywords: Obesity
Obesity
Gestational Diabetes
Gestational Diabetes
Published in: Endocrine
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-024-03776-6

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