To identify potential further biological pathways that influence menarche timing, we used a gene set enrichment analysis (GSEA) approach in MAGENTA, in which each gene in the genome is assigned an adjusted score that represents its association with age at menarche, and predefined pathways are tested for enrichment of multiple associations (see Methods). The most significant pathway was the biosynthesis of Coenzyme A, which is a carrier of acyl groups and is necessary for pyruvate oxidation and fatty acid synthesis and oxidation (Supplementary Table 9).
