Vitamin D deficiency and age at menarche: a prospective study

Abstract

Background: Early menarche is a risk factor for cardiometabolic disease and cancer. Latitude, which influences sun exposure, is inversely related to age at menarche. This association might be related to vitamin D, but to our knowledge it has not been investigated in prospective epidemiologic studies.

Objective: We studied the association between vitamin D status and the occurrence of menarche in a prospective study in girls from Bogota, Colombia.

Design: We measured plasma 25-hydroxyvitamin D [25(OH)D] concentrations in a random sample of 242 girls (mean ± SD age: 8.8 ± 1.6 y) and followed them for a median of 30 mo. Girls were asked periodically about the occurrence and date of menarche. Baseline 25(OH)D concentrations were categorized as <50 nmol/L (deficient), ≥50 and <75 nmol/L, or ≥75 nmol/L (sufficient). The incidence of menarche was compared between groups by using time-to-event analyses.

Results: A total of 57% of girls in the vitamin D-deficient group reached menarche during follow-up compared with 23% of girls in the vitamin D-sufficient group (P-trend = 0.0004). The estimated mean (±SE) ages at menarche in the same groups were 11.8 ± 0.2 y and 12.6 ± 0.2 y, respectively (P = 0.0009). After adjustment for baseline age and BMI-for-age z score in a Cox proportional hazards model, the probability of menarche was twice as high in vitamin D-deficient girls than in girls who were vitamin D-sufficient (HR: 2.05; 95% CI: 1.03, 4.07; P = 0.04). Similar results were obtained in girls aged ≥9 y at baseline (HR: 2.39; 95% CI: 1.14, 5.00; P = 0.02).

Conclusion: Vitamin D deficiency is associated with earlier menarche.

FIGURE 1.

Cumulative probabilities of reaching menarche according to plasma concentrations of 25(OH)D in 242 Colombian school-age girls. The proportions of girls who reached menarche during a median of 30 mo of follow-up in groups with 25(OH)D concentrations of <50 nmol/L (deficient), ≥50 and <75 nmol/L, or ≥75 nmol/L (sufficient) were 57% (n = 16 of 28), 40% (n = 49 of 124), and 23% (n = 21 of 90), respectively (P = 0.0004, Cochrane-Armitage test for trend). 25(OH)D, 25-hydroxyvitamin D.