Women who have their first menstrual period before the age of 13 are more likely than others to suffer from type 2 diabetes in their lifetime and those who have it by the age of 10 are also more likely to have a stroke by the age of 65. This results from the results of one studio published on BMJ Nutrition Prevention & Health conducted by researchers from Tulane University School of Public Health di New Orleans e from Harvard Medical School in Boston. Who wanted to understand if there was a connection between diabetes and the age of the first menstruation, in a historical phase, ours, in which the numbers of the disease increase, and the age of the cycle decreases.
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The US study
To do this, they analyzed data collected on 17,377 women between 20 and 65 years old enrolled in Nhanes, National health and nutrition examination survey 1999-2018, who were asked the age of menarche (the age of the first menstruation) and the diseases from which they possibly suffered, including diabetes. We are talking about a global priority. Worldwide, over 530 million adults are affected by it, and by 2030 it could be 640 million. In Europe, diabetes affects around 60 million adults, and according to ISTAT data from 2020 in Italy the prevalence is 6%, which corresponds to over 3 and a half million people: in 90% of cases it is type 2 diabetes .
The search results
Returning to the study, 1,773 women, i.e. 10% of the total, reported a diagnosis of type 2 diabetes and of these, 205 (i.e. 11.5%) declared they suffered from some cardiovascular disease. Taking into account confounding factors, i.e. potentially capable of influencing the results (age, ethnic origin, level of education, maternity, menopause and family history of diabetes, and then smoking, physical activity, alcohol consumption and body weight), the starting the menstrual cycle before the age of 13 was associated with a clear increase in the risk of type 2 diabetes. Which increased by 32% in the case of menarche at 10 years or less than 10 years, by 14% in the case of menarche at 11 years and 29% in the case of menarche at 12 years. Furthermore, among diabetic women with a very early first menstrual cycle (10 years or less) a more than double risk of stroke was found, a risk that decreased as the age of first menstruation increased.
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A possible indicator
It is an observational study, therefore it is not able, nor does it want, to establish causal relationships, but to find connections and associations. In any case, however, the first menstrual cycle according to the authors “could be an early indicator… of cardio-metabolic disease in women’s lives”. But what could be the thread that connects diabetes and age of menstruation? According to the researchers who signed the work, hormones are involved: estrogen in particular.
“The only biological mechanism that can explain these findings is elevated estrogen production,” he explains Giorgio Sestiprofessor of Internal Medicine at Sapienza University of Rome and honorary president of the Italian Society of Diabetology. He adds: “Several published studies have shown that high estrogen production and prolonged exposure to these hormones, which are both phenomena that occur in women with early menarche, favor insulin resistance, which is one of the pathogenetic factors which cause diabetes. Another factor is adiposity: body fat promotes early menarche and is also a diabetic risk factor.”
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“This is an observational study, although well done and on a large sample of women – concludes Sesti -. However, if it is confirmed by pathophysiological studies, as is generally done, we will be able to use the age of the first menstrual cycle to intercept the pathology early diabetic, as we do with other risk factors, for example with family history. And also to prevent the disease, inviting women with a very early cycle to follow a healthier lifestyle”.