Association of age at menarche with valvular heart disease: An analysis based on electronic health record (CREAT2109)

Zhiyu Sun; Yongjie Zhu; Xiaoyan Sun; Zhexun Lian; Mengqi Guo; Xiaohong Lu; Ting Song; Luxin Feng; Yi Zhang; Yawei Xu; Hongwei Ji; Junjie Guo

doi:10.3389/fcvm.2023.1029456

Association of age at menarche with valvular heart disease: An analysis based on electronic health record (CREAT2109)

Front Cardiovasc Med. 2023 Apr 17:10:1029456. doi: 10.3389/fcvm.2023.1029456. eCollection 2023.

Authors

Zhiyu Sun^{1

2

3}, Yongjie Zhu⁴, Xiaoyan Sun⁵, Zhexun Lian^{1

2}, Mengqi Guo¹, Xiaohong Lu¹, Ting Song³, Luxin Feng³, Yi Zhang⁶, Yawei Xu⁶, Hongwei Ji^{1

2}, Junjie Guo^{1

2

7}

Affiliations

¹ Department of Cardiology, The Affiliated Hospital of Qingdao University, Qingdao, China.
² Chinese Patient-Oriented Metabolic and Ischemic Risk Evaluation (CREAT) Study, Qingdao, China.
³ Qingdao University, Qingdao Medical College, Qingdao, China.
⁴ Department of Emergency Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China.
⁵ Department of Geriatrics, Qingdao Eighth People's Hospital, Qingdao, China.
⁶ Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
⁷ Qingdao Municipal Key Laboratory of Hypertension (Key Laboratory of Cardiovascular Medicine), Qingdao, China.

Abstract

Background: The association between age at menarche and coronary heart disease has been reported, but the association between age at menarche and valvular heart disease (VHD) has not been described. We aimed to examine the association between age at menarche and VHD.

Methods: By collecting data from four medical centers of the Affiliated Hospital of Qingdao University (QUAH) from January 1, 2016, to December 31, 2020, we sampled 105,707 inpatients. The main outcome of this study was newly diagnosed VHD, which was diagnosed based on ICD-10 coding, and the exposure factor was age at menarche, which was accessed through the electronic health records. We used logistic regression model to investigate the association between age at menarche and VHD.

Results: In this sample (mean age 55.31 ± 13.63 years), the mean age at menarche was 15. Compared with women with age at menarche 14-15 years, the odds ratio of VHD in women with age at menarche ≤13, 16-17, and ≥18 years was 0.68 (95% CI 0.57-0.81), 1.22 (95% CI 1.08-1.38), and 1.31 (95% CI 1.13-1.52), respectively (P for all < 0.001). By restricting cubic splines, we found that later menarche was associated with increased odds of VHD (P < 0.001). Furthermore, in subgroup analysis of different etiologies, the similar trend persisted for non-rheumatic VHD.

Conclusions: In this large inpatient sample, later menarche was associated with higher risk of VHD.

Keywords: age at menarche; electronic health records; heart valve diseases; reproductive history; risk factors.

Grants and funding

This study was funded in part by Taishan Scholar Program of Shandong Province (tsqn202211364), Qingdao Outstanding Health Professional Development Fund, the National Natural Science Foundation of China (Grant ID: 82103908 and 82000417), and the Shandong Provincial Natural Science Foundation (ZR2021QH014). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.