Abstract
Disclosure: F.R. Tinano: None. I.F. Machado: None. I.M. Bensenor: None. P.A. Lotufo: None. A. Latronico: None. L.G. Gomes: None.
Context: Age at menarche (AAM), whether early or late, has been linked to a wide range of cardiometabolic and reproductive outcomes. However, findings across studies are inconsistent, and data from developing countries remain scarce. This study investigated the association between early and late AAM with health outcomes in Brazilian women from the ELSA-Brazil cohort.Methods: The ELSA-Brazil study integrates cross-sectional and prospective cohort analyses of 15,105 civil servants from six centers across Brazil. Initiated in 2008, participants underwent four longitudinal evaluations, including interviews, anthropometric assessments, and biochemical tests. For this analysis, we included 7,623 women aged 35–74 years who participated in the second evaluation (2012-2014). Early and late AAM were defined as <10 and >15 years, respectively. Metabolic outcomes included obesity, central obesity, type 2 diabetes mellitus (T2DM), dyslipidemia, hypertension, metabolic syndrome, and hepatic steatosis on ultrasound. Laboratory data reflecting metabolic health were also analyzed. Reproductive outcomes included oligomenorrhea, hirsutism, self-reported polycystic ovary syndrome, pre-eclampsia, gestational diabetes, and infertility/subfertility. Cardiovascular outcomes included self-reported myocardial infarction (MI), angina, myocardial revascularization, stroke, and heart failure. Multivariable analyses were adjusted for age, race, education, smoking, alcohol intake, and physical activity, with statistical significance set at p<0.05.Results: Early AAM was associated with higher odds of multiple adverse outcomes in both univariable and multivariable analyses: obesity (OR 2.18/2.08), hypertension (OR 1.38/1.36), T2DM (OR 1.85/1.92), metabolic syndrome (OR 1.58/1.57), elevated uric acid (OR 1.47/1.48), pre-eclampsia (OR 1.71/1.67), self-reported angina (OR 1.76/1.68), MI (OR 2.33/2.59), and heart failure (OR 2.50/2.60) (all p<0.05). Central obesity was linked with early AAM in univariate analysis (OR 1.52, p=0.02), with a trend toward significance in multivariable analysis (OR 1.44, p=0.053). Late AAM showed a protective association with obesity in multivariable analysis (OR 0.69, p=0.002). Conversely, late AAM was linked to higher odds of oligomenorrhea and myocardial revascularization in both univariable and multivariable analyses (OR 1.47/1.62 and 3.20/2.40, respectively, p<0.05). Associations of late AAM with T2DM, metabolic syndrome, angina, and heart failure were only significant in univariable analyses (OR 1.30, 1.24, 1.60, and 2.06, respectively, p<0.05).Conclusions: AAM represents an important marker of cardiometabolic and reproductive health. Early and late AAM were associated with distinct health risks, emphasizing the need for tailored preventive strategies in women’s health, particularly in underrepresented populations.
Presentation: Sunday, July 13, 2025