Causal relationship between the timing of menarche and young adult body mass index with consideration to a trend of consistently decreasing age at menarche

PLoS One. 2021 Feb 26;16(2):e0247757. doi: 10.1371/journal.pone.0247757. eCollection 2021.

Abstract

Younger age at menarche (AAM) is associated with higher body mass index (BMI) for young women. Considering that continuous trends in decreasing AAM and increasing BMI are found in many countries, we attempted to assess whether the observed negative association between AAM and young adult BMI is causal. We included 4,093 women from the Korean Genome and Epidemiology Study (KoGES) and Healthy twin Study (HTS) with relevant epidemiologic data and genome-wide marker information. To mitigate the remarkable differences in AAM across generations, we converted the AAM to a generation-standardized AAM (gsAAM). To test causality, we applied the Mendelian randomization (MR) approach, using a genetic risk score (GRS) based on 14 AAM-associated single nucleotide polymorphisms (SNPs). We constructed MR models adjusting for education level and validated the results using the inverse-variance weighted (IVW), weighted median (WM), MR-pleiotropy residual sum and outliers test (MR-PRESSO), and MR-Egger regression methods. We found a null association using observed AAM and BMI level (conventional regression; -0.05 [95% CIs -0.10-0.00] per 1-year higher AAM). This null association was replicated when gsAAM was applied instead of AAM. Using the two-stage least squares (2SLS) approach employing a univariate GRS, the association was also negated for both AAM and gsAAM, regardless of model specifications. All the MR diagnostics suggested statistically insignificant associations, but weakly negative trends, without evidence of confounding from pleiotropy. We did not observe a causal association between AAM and young adult BMI whether we considered the birth cohort effect or not. Our study alone does not exclude the possibility of existing a weak negative association, considering the modest power of our study design.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age Factors
  • Body Mass Index*
  • Causality
  • Child
  • Female
  • Genetic Pleiotropy
  • Genome, Human
  • Genome-Wide Association Study
  • Humans
  • Menarche / genetics*
  • Mendelian Randomization Analysis
  • Menstruation / genetics*
  • Polymorphism, Single Nucleotide*
  • Prospective Studies
  • Republic of Korea
  • Twin Studies as Topic
  • Young Adult

Grants and funding

This work was supported by the National Research Foundation of Korea grant (NRF-2016R1D1A1B03933410, 2018R1D1A1B07048821, 2018R1A6A3A01012922 and 2020R1C1C1013980) funded by the Korean Government. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.