Objective To examine the association of menarche timing with cardiometabolic risk

Objective To examine the association of menarche timing with cardiometabolic risk factors into early to mid-adulthood comparing African-American and White colored women. (0.88±0.12 kg/m2 p<.0001) and White colored (0.89±0.10 kg/m2 p<.0001) ladies. After BMI adjustment each one-year earlier age at menarche was associated with higher triglycerides (2.26±0.68 mg/dl p=0.001) and glucose (0.34±0.11 mg/dl p=0.002) and greater risk for event impaired fasting glucose (HR=1.13 95% CI 1.04-1.20) and metabolic syndrome (HR=1.19 95 CI 1.11-1.26) among white colored ladies only. Conclusions Extra adiposity associated with earlier menarche is sustained through mid-adulthood and primarily drives higher cardiometabolic risk element levels. However White colored ladies with earlier menarche experienced improved risk of a number of insulin-resistance related conditions self-employed Tipranavir of adiposity. The cardiometabolic effect of earlier menarche was weaker in African-American ladies despite higher average adiposity. Excess weight maintenance would likely reduce but may not completely eliminate the elevated Tipranavir cardiometabolic risk of earlier menarche. research query was about race differences in associations. The proportional risks assumption was tested and verified by generating a time-dependent predictor and creating relationships of age at menarche and a log function of survival time and then the Wald chi-square process tested whether the coefficients were equal to 0. Separate repeated steps linear regression models accounting for the correlated nature of the data were used to examine the association of age at menarche with each cardiometabolic risk element (BMI waist circumference total cholesterol triglycerides LDL-C HDL-C blood pressure insulin and glucose) over 25 years of follow up. All models included the self-employed variables continuous age at menarche follow-up 12 months (the time variable) age and age2 and medical center and assumed a compound symmetry correlation matrix. The cardiometabolic risk factors were dependent continuous variables in each of the independent models. Models were run in a series by adding covariates starting with Tipranavir minimally modified Model 1 (age age2 center and time). Model 2 also included variables that were associated with age at menarche and/or cardiometabolic risk factors in prior studies: race (other than for race-stratified models) alcohol use education smoking status physical activity prior to high school physical activity during high school baseline physical activity parental history of diabetes oral contraceptive use and menopause status. Blood pressure models additionally modified for use of antihypertensive medication use (yes/no) and lipid models for cholesterol-lowering medications use (yes/no). Finally to test whether associations were self-employed of adiposity the models were further modified by Tipranavir the addition of baseline (age 18-30 years) BMI (kg/m2) in Model 3. Most models indicated linear dose-response effects of age at menarche. Consequently age at menarche was included as continuous variable in the repeated regression models except for display of modified means for each menarche category (early average past due) for BMI and waist circumference PEPCK-C at each CARDIA check out in the Number. To test for variations by race modified models were run with an connection term (race*menarche age). Number 1 Modified* mean adiposity levels during adulthood by age at menarche category in the CARDIA Study All analyses were run in SAS version 9.2. The alpha statistical significance level was arranged at p<0.05 for the Cox proportional risk models and relationships. Bonferroni corrected p-values <0.005 (p=0.05/10 outcomes) were considered to be statistically significant for the purposes of the longitudinal analyses to adjust for multiple comparisons. Results After exclusions the overall cohort of 2 583 ladies experienced a mean age of 25 years at baseline (range=18-30 years) and 50 years at the final check out (range=42-59 years). At the year 25 check out our overall cohort included 1 849 ladies. The mean age at menarche was 12.6 years (SD=1.5) for the total sample and was younger for African-American (12.5 years SD=1.5) compared with White colored (12.7 years SD=1.5) women (t=?3.66 p-value<.001). Table I shows the unadjusted baseline characteristics of the study sample.