Abstract MP68: Age at Menarche is Inversely Associated with Liver Steatosis and Abdominal Fat Depots: CARDIA Study

Abstract

Introduction: Age at menarche is associated with cardiometabolic disease risk later in life; whether hepatic steatosis (fatty liver) or regional depots of abdominal fat play a role in this association is unclear. In a community-based sample of African American and White women free of diagnosed liver disease, we tested the hypothesis that age at menarche is inversely associated with hepatic steatosis and abdominal fat depots in midlife, after control for demographic and lifestyle factors and early adult BMI. Methods: Women in the Coronary Artery Risk Development in Young Adults (CARDIA) study with complete measures of recalled age at menarche (at exam years 0 (1985-86) and 2), multiple slice abdominal CT (at year 25) of hepatic steatosis (HS), visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IAT) were included. We defined nonalcoholic fatty liver disease as liver attenuation ≤ 48 Hounsfield units (HU) after excluding other causes of liver disease. We used multivariable linear regression (continuous outcomes) and Poisson regression (binary outcomes). Results: The mean (±sd) menarcheal age for the 1215 women eligible for this analysis was 12.6±1.5 y. A 1-year increment in age at menarche was associated with lower liver steatosis (0.8±0.2 HU; greater HU = less steatosis), VAT (-6.6±1.2 cc), IAT (-7.3±1.4 cc), SAT (-19.3±3.3 cc), and NAFLD prevalence (prevalence ratio=0.86; 95% CI: 0.78, 0.94) after confounder adjustment ( Table ). Associations remained after further adjustment for year 0 BMI (ages 18-30 y; all p for trend <0.05), but were attenuated (all p for trend >0.05) after adjustment for year 25 BMI (a mediator) when participants were 43-55 y. Conclusion: These findings indicate age at menarche is inversely associated with midlife liver steatosis and visceral and subcutaneous abdominal fat, independent of early, but not late, adult BMI. Whether these associations mediate the higher cardiometabolic disease risk observed in early maturing females needs to be determined.