Early age at menarche is associated with insulin resistance: a systemic review and meta-analysis

ABSTRACT

Objectives: We aimed to conduct a systemic review and meta-analysis of the relevant studies to further investigate the association between age at menarche and insulin resistance.

Methods: PubMed, EMBASE, and Web of Science (SCI) databases were systemically searched until December 2017. Observational studies comparing the incidences of insulin resistance in patients with early, average, and late menarchal ages were identified. Weighted mean difference (WMD) for HOMA-IR scores and fasting serum insulin levels in early vs late, early vs average. and average vs late comparisons were calculated with a random- or fixed-effects model.

Results: A total of eight articles involving 5504 subjects were finally included. In the analysis of HOMA-IR, the pooled WMDs in five studies were 0.45 (95% confidence interval [CI] 0.31–0.60, p < 0.001), 0.40 (95% CI 0.28–0.52, p < 0.001), and −0.01 (95% CI −0.09 to 0.07, p = 0.854) for early vs late, early vs average, and average vs late comparisons, respectively. The fasting serum insulin levels in eight studies were analyzed, and it was significantly higher in subjects with earlier age at menarche (WMD 1.28, 95% CI 0.92–1.63, p < 0.001 for early vs late comparison, WMD 1.28, 95% CI 1.13–1.43, p < 0.001 for early vs average comparison) with mild and acceptable heterogeneity (I² = 42.5% and 7.4%, respectively). Publication bias was not detected via funnel plots and Egger’s tests.

Conclusions: Our study revealed that earlier age at menarche was significantly associated with insulin resistance.

Trial Registration Number: CRD42018083874

KEYWORDS:

• Age at menarche
• insulin resistance
• HOMA-IR
• meta-analysis

Acknowledgments

The authors thank Dr Chen, who has been a source of encouragement.

Author contributions

Zhipeng Zhang contributed to the study concept, literature retrieval, quality assessment, data analysis, and manuscript writing. Xianjin Hu contributed to literature retrieval, quality assessment, and data extraction. Changqiang Yang contributed to data extraction. Xiaoping Chen contributed to manuscript revision.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. Peer reviewers on this manuscript have no relevant financial relationships to disclose.

Conflict of interests

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Additional information

Funding

This manuscript was not funded.