HEINER BOEING, PHD10

OBJECTIVEdYounger age atmenarche, amarker of pubertal timing in girls, is associatedwith higher risk of later type 2 diabetes.We aimed to confirm this association and to examine whether it is explained by adiposity. RESEARCH DESIGN ANDMETHODSdThe prospective European Prospective Investi-gation into Cancer andNutrition (EPIC)-InterAct case-cohort study consists of 12,403 incident type 2 diabetes cases and a stratified subcohort of 16,154 individuals from26 research centers across eight European countries.We tested the association between age atmenarche and incident type 2 diabetes using Prentice-weighted Cox regression in 15,168 women (n = 5,995 cases). Models were adjusted in a sequential manner for potential confounding and mediating factors, including adult BMI. RESULTSdMean menarcheal age ranged from 12.6 to 13.6 years across InterAct countries. Each year later menarche was associated with 0.32 kg/m2 lower adult BMI.Women in the earliest menarche quintile (8–11 years, n = 2,418) had 70%higher incidence of type 2 diabetes compared with those in the middle quintile (13 years, n = 3,634), adjusting for age at recruitment, research center, and a range of lifestyle and reproductive factors (hazard ratio [HR], 1.70; 95 % CI, 1.49– 1.94; P, 0.001). Adjustment for BMI partially attenuated this association (HR, 1.42; 95 % CI