Menarchal Timing in Type 1 Diabetes Through the Last 4 Decades

Abstract

OBJECTIVE We sought to examine whether age at menarche has changed over the past 4 decades by comparing age at menarche by year of diagnosis with type 1 diabetes. RESEARCH DESIGN AND METHODS This work consisted of a cross-sectional study of age at menarche in two cohorts: adolescents (ages 11–24 years, n = 228) and adults (ages 19–55 years, n = 290, enrolled in the Coronary Artery Calcification in Type 1 Diabetes study). RESULTS The adolescent cohort reported a younger age of menarche than the adult women with type 1 diabetes (12.69 ± 0.08 vs. 13.22 ± 0.12 years, mean ± SE, P < 0.001). Age at menarche was later in both adolescent girls and adult women with type 1 diabetes diagnosed before menarche (12.82 ± 1.16 and 13.7 ± 2.23 years) than for individuals diagnosed after menarche (12.12 ± 1.25 and 12.65 ± 1.38 years, P < 0.001 for both). Age at menarche was then examined by decade of type 1 diabetes diagnosis (1970–1979, 1980–1989, 1990–1999, and 2000–2009). Age at menarche significantly declined over the 4 decades (P = 0.0002). However, the delay in menarche among girls diagnosed with type 1 diabetes before menarche compared with those diagnosed after menarche was also significant across all decades (P < 0.0001) and did not change significantly over time (P = 0.41 for interaction of cohort and diagnosis premenarche). CONCLUSIONS Age at menarche has declined over the past 4 decades among girls with type 1 diabetes, but a delay in age at menarche remains among individuals diagnosed before menarche compared with individuals diagnosed after menarche.