Early Age at Menarche Associated with Cardiovascular Disease and Mortality (original) (raw)
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1Medical Research Council Epidemiology Unit (R.L., N.G.F., S.J.S., N.J.W., K.K.O.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
2Department of Public Health and Primary Care (R.L., K.-T.K.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
*Address all correspondence and requests for reprints to: Rajalakshmi Lakshman, M.D., MRCP, MFPH, Medical Research Council Epidemiology Unit, Institute of Metabolic Science, Addenbrooke’s Hospital Box 285, Cambridge CB2 0QQ, United Kingdom.
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1Medical Research Council Epidemiology Unit (R.L., N.G.F., S.J.S., N.J.W., K.K.O.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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1Medical Research Council Epidemiology Unit (R.L., N.G.F., S.J.S., N.J.W., K.K.O.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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1Medical Research Council Epidemiology Unit (R.L., N.G.F., S.J.S., N.J.W., K.K.O.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
2Department of Public Health and Primary Care (R.L., K.-T.K.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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4Centre for Nutritional Epidemiology in Cancer Prevention (S.A.B.), Cambridge CB1 8RN, United Kingdom
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2Department of Public Health and Primary Care (R.L., K.-T.K.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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1Medical Research Council Epidemiology Unit (R.L., N.G.F., S.J.S., N.J.W., K.K.O.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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3Institute of Public Health, and Department of Paediatrics (K.K.O.), University of Cambridge, Cambridge CB2 0QQ, United Kingdom
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Accepted:
24 September 2009
Published:
01 December 2009
Cite
Rajalakshmi Lakshman, Nita G. Forouhi, Stephen J. Sharp, Robert Luben, Sheila A. Bingham, Kay-Tee Khaw, Nicholas J. Wareham, Ken K. Ong, Early Age at Menarche Associated with Cardiovascular Disease and Mortality, The Journal of Clinical Endocrinology & Metabolism, Volume 94, Issue 12, 1 December 2009, Pages 4953–4960, https://doi.org/10.1210/jc.2009-1789
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Context: The relationship between age at menarche and cardiovascular disease remains unclear. Two recent studies found an inverse association between age at menarche and all-cause mortality.
Objective: The aim of this study was to examine the relationship between age at menarche and cardiovascular disease risk factors, events, and mortality.
Design, Setting, and Participants: A population-based prospective study involving 15,807 women, aged 40–79 yr in 1993–1997 and followed up to March 2007 for cardiovascular disease events (median follow-up 10.6 yr) and February 2008 for mortality (median follow-up 12.0 yr) was used.
Main Outcome Measures: Odds ratios for cardiovascular disease risk factors and hazard ratios for incident cardiovascular disease and mortality were calculated.
Results: There were 3888 incident cardiovascular disease events (1323 coronary heart disease, 602 stroke, and 1963 other) and 1903 deaths (640 cardiovascular disease, 782 cancer, and 481 other) during follow-up. Compared with other women, those who had early menarche (<12 yr) had higher risks of hypertension [1.13 (1.02–1.24)], incident cardiovascular disease [1.17 (1.07–1.27)], incident coronary heart disease [1.23 (1.06–1.43)], all-cause mortality [1.22 (1.07–1.39)], cardiovascular disease mortality [1.28 (1.02–1.62)], and cancer mortality [1.25 (1.03–1.51)], adjusted for age, physical activity, smoking, alcohol, educational level, occupational social class, oral contraceptive use, hormone replacement therapy, parity, body mass index, and waist circumference.
Conclusions: Early age at menarche (before age 12 yr) was associated with increased risk of cardiovascular disease events, cardiovascular disease mortality, and overall mortality in women, and this association appeared to be only partly mediated by increased adiposity.
Copyright © 2009 by The Endocrine Society
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