Valma Harjutsalo1,2,3,4, Christine Maric-Bilkan5, Carol Forsblom1,2,3, Per-Henrik Groop6,7,8,9. 1. Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, PO Box 63, 00014, Helsinki, Finland. 2. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. 4. The Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland. 5. Vascular Biology and Hypertension Branch, Division of Cardiovascular Sciences, National Institute of Heart, Lung and Blood, National Institutes of Health, Bethesda, MD, USA. 6. Folkhälsan Research Center, Biomedicum Helsinki, University of Helsinki, PO Box 63, 00014, Helsinki, Finland. per-henrik.groop@helsinki.fi. 7. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. per-henrik.groop@helsinki.fi. 8. Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. per-henrik.groop@helsinki.fi. 9. Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. per-henrik.groop@helsinki.fi.
Abstract
AIMS/HYPOTHESIS: The aim of this study was to evaluate the relationship among age at onset of diabetes, age at onset of menarche and risk of diabetic nephropathy and laser-treated retinopathy in type 1 diabetes. METHODS: Data related to age at menarche were collected through questionnaires and were available for 1,304 women who participated in the Finnish Diabetic Nephropathy Study (FinnDiane). A possible association between age at menarche and diabetic nephropathy and retinopathy was investigated. RESULTS: There was an inverse relationship between the age at onset of diabetes and age at menarche: the younger the age at onset of diabetes, the higher the age at menarche (p < 0.0001). A non-linear relationship between the age of menarche and risk of diabetic microvascular complications was found in patients with diabetes onset before menarche, but there was no such association in patients with diabetes onset after menarche. Women with delayed menarche (> mean age + 2 years) had a 2.30 (95% CI 1.27, 4.17; p < 0.006) times higher risk of nephropathy compared with the women who underwent menarche at the mean age ± 2 years. Delayed menarche also increased the risk of retinopathy (OR 2.34 [95% CI 1.36, 4.01]). After excluding patients with nephropathy, the OR for retinopathy was 2.11 (95% CI 1.15, 3.90). Earlier menarche (< mean age - 2 years) did not have any effect on this risk. CONCLUSIONS/ INTERPRETATION: Delayed menarche was associated with an increased risk of diabetic nephropathy and retinopathy, whereas early menarche was not. Delayed menarche may be used as a new tool to identify women at risk of diabetic microvascular complications.
AIMS/HYPOTHESIS: The aim of this study was to evaluate the relationship among age at onset of diabetes, age at onset of menarche and risk of diabetic nephropathy and laser-treated retinopathy in type 1 diabetes. METHODS: Data related to age at menarche were collected through questionnaires and were available for 1,304 women who participated in the Finnish Diabetic Nephropathy Study (FinnDiane). A possible association between age at menarche and diabetic nephropathy and retinopathy was investigated. RESULTS: There was an inverse relationship between the age at onset of diabetes and age at menarche: the younger the age at onset of diabetes, the higher the age at menarche (p < 0.0001). A non-linear relationship between the age of menarche and risk of diabetic microvascular complications was found in patients with diabetes onset before menarche, but there was no such association in patients with diabetes onset after menarche. Women with delayed menarche (> mean age + 2 years) had a 2.30 (95% CI 1.27, 4.17; p < 0.006) times higher risk of nephropathy compared with the women who underwent menarche at the mean age ± 2 years. Delayed menarche also increased the risk of retinopathy (OR 2.34 [95% CI 1.36, 4.01]). After excluding patients with nephropathy, the OR for retinopathy was 2.11 (95% CI 1.15, 3.90). Earlier menarche (< mean age - 2 years) did not have any effect on this risk. CONCLUSIONS/ INTERPRETATION: Delayed menarche was associated with an increased risk of diabetic nephropathy and retinopathy, whereas early menarche was not. Delayed menarche may be used as a new tool to identify women at risk of diabetic microvascular complications.
Entities:
Keywords:
Age at menarche; Age at onset of diabetes; Delayed menarche; Diabetic nephropathy; Diabetic retinopathy; Puberty; Type 1 diabetes
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