Age at menarche and metabolic dysfunction-associated fatty liver disease: Evidence from a large population-based epidemiological study in Southwest China

Kehan Li; Jianzhong Yin; Zixiu Qin; Bangjing Ma; Ruifeng He; Duoji Zhuoma; Zihao Wang; Qiaolan Liu; Xing Zhao

doi:10.1016/j.ypmed.2023.107776

Age at menarche and metabolic dysfunction-associated fatty liver disease: Evidence from a large population-based epidemiological study in Southwest China

Prev Med. 2023 Dec:177:107776. doi: 10.1016/j.ypmed.2023.107776. Epub 2023 Nov 10.

Authors

Kehan Li¹, Jianzhong Yin², Zixiu Qin³, Bangjing Ma⁴, Ruifeng He⁵, Duoji Zhuoma⁶, Zihao Wang⁷, Qiaolan Liu⁸, Xing Zhao⁹

Affiliations

¹ Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.
² Department of Nutrition and Food Hygiene, School of Public Health, Kunming Medical University, Kunming, Yunan, China; Baoshan College of Traditional Chinese Medicine, Baoshan, Yunan, China.
³ School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou, China.
⁴ Qingbaijiang District Center for Disease Control and Prevention, Chengdu, Sichuan, China.
⁵ Tibet Center for Disease Control and Prevention, Lhasa, Tibet, China.
⁶ School of Medicine, Tibet University, Lhasa, Tibet, China.
⁷ Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China.
⁸ Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China. Electronic address: liuqiaol@scu.edu.cn.
⁹ Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China.

PMID: 37951543
DOI: 10.1016/j.ypmed.2023.107776

Abstract

Background: The relationship between age at menarche and metabolic dysfunction-associated fatty liver disease remains largely not clear. The objective of this study was to examine the association between age at menarche (AAM) and metabolic dysfunction-associated fatty liver disease (MAFLD) in Chinese women and whether any observed associations were mediated by early adulthood adiposity.

Methods: The cross-sectional study included 46,873 Chinese women, aged 30-79 from baseline data of the China Multi-Ethnic Cohort study. Logistic regression models were used to evaluate the association between AAM and MAFLD. Mediation analysis was adopted to examine whether early adulthood adiposity (around 25 years) mediated the association between AAM and MAFLD.

Results: AAM was linearly and inversely associated with the risk of MAFLD (P for nonlinearity =0.743). In a multivariable-adjusted model, the odds ratios and 95% confidence interval (ORs (95% CI)) for MAFLD comparing menarche at <12, 12, 13, 15, 16, 17, ≥18 years to menarche at 14 years were 1.290 (1.082-1.537), 1.172 (1.068-1.285), 1.042 (0.960-1.131), 0.937 (0.861-1.020), 0.911(0.835-0.994), 0.868 (0.786-0.959), and 0.738 (0.670-0.814), respectively (P for trend <0.001). The 6.4% increased MAFLD risk was associated with each preceding year in AAM. The association between AAM and MAFLD was modified by age, ethnicity, and menopause. Early adulthood adiposity partially mediated this association.

Conclusion: The findings of this study suggest that obesity prevention strategies are needed from young adulthood in women who undergo early menarche to reduce the risk of MAFLD.

Keywords: Age at menarche; Early adulthood adiposity; Epidemiological study; Mediation analysis; Metabolic dysfunction-associated fatty liver disease.

MeSH terms

Adult
Age Factors
China / epidemiology
Cohort Studies
Cross-Sectional Studies
Female
Humans
Liver Diseases* / complications
Menarche
Non-alcoholic Fatty Liver Disease* / complications
Non-alcoholic Fatty Liver Disease* / epidemiology
Obesity / complications
Young Adult