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Journal of Clinical Endocrinology & Metabolism, doi:10.1210/jc.2004-1991
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The Journal of Clinical Endocrinology & Metabolism Vol. 90, No. 5 2718-2724
Copyright © 2005 by The Endocrine Society

Early Menarche and the Development of Cardiovascular Disease Risk Factors in Adolescent Girls: The Fels Longitudinal Study

Karen E. Remsberg, Ellen W. Demerath, Christine M. Schubert, Wm. Cameron Chumlea, Shumei S. Sun and Roger M. Siervogel

Lifespan Health Research Center, Department of Community Health, Wright State University School of Medicine, Kettering, Ohio 45420

Address all correspondence and requests for reprints to: Dr. Karen E. Remsberg, Lifespan Health Research Center, Wright State University School of Medicine, 3171 Research Boulevard, Kettering, Ohio 45420-4006. E-mail: karen.remsberg{at}wright.edu.

The purpose of this study was to evaluate the influence of menarcheal age on changes in insulin, glucose, lipids, and blood pressure during adolescence and to assess whether body composition modifies this relationship. We examined 391 girls, a subset of Fels Longitudinal Study female participants (8–21 yr of age). Self-reported menarcheal age was classified based on the National Health and Nutrition Examination Survey III distribution, in which early menarche was at the 25th percentile or less (11.9 yr). Age at menarche was examined in relation to measures of body composition [e.g. fat-free mass (FFM) and percent body fat (PBF)], insulin resistance, blood pressure, and lipid profile. The effects of menarcheal age and body composition on cardiovascular disease risk factor changes were analyzed with serial data mixed models. Median menarcheal age was 12.7 yr (range, 9.8–17.0 yr), with 91 girls (23%) classified as early menarche. Girls with early menarche had more deleterious changes in insulin, glucose, blood pressure, FFM, and PBF levels than girls with average or late menarche. Menarcheal age adversely affected cardiovascular disease risk factor changes independent of age and changes in FFM or PBF. Girls with early menarche exhibited elevated blood pressure and glucose intolerance compared with later maturing girls, independent of body composition.




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