BackgroundThe aim of the present study was to investigate whether age at menarche is associated with non-alcoholic fatty liver disease (NAFLD) later in life. MethodsThe association between age at menarche and obesity, insulin resistance, and NAFLD after menopause was investigated in a cross-sectional study of 4128 postmenopausal Chinese women; NAFLD was diagnosed by hepatic ultrasound and information regarding age at menarche was collected using an interviewer-administered questionnaire. ResultsWomen with age at menarche18years. Logistic regression revealed that women with earlier menarche had a higher risk for the age-adjusted prevalence of overweight/obesity, insulin resistance, and NAFLD, whereas later menarche showed a weaker, but still significant, association with a lower prevalence of NAFLD. However, further adjustment for some variables and current body mass index (BMI) or homeostasis model assessment of insulin resistance (HOMA-IR) attenuated the association between later menarche and a lower prevalence of NAFLD. A decreasing trend in the risk of NAFLD was seen across increasing levels of age at menarche (age-adjusted P-trend<0.001; multivariate-adjusted P-trend<0.001; multivariate + current BMI-adjusted P-trend=0.03; multivariate + HOMA-IR-adjusted P-trend=0.06). ConclusionAge at menarche is associated with the prevalence of NAFLD later in life, independent of BMI and insulin resistance.