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Diabetologia. 2017 Oct;60(10):1951-1960. doi: 10.1007/s00125-017-4346-8. Epub 2017 Jul 18.

Age at natural menopause and risk of type 2 diabetes: a prospective cohort study.

Author information

1
Department of Epidemiology, Erasmus University Medical Center, Dr. Molewaterplein 50, Office NA29-14, PO Box 2040, 3000 CA, Rotterdam, the Netherlands. t.muka@erasmusmc.nl.
2
Department of Epidemiology, Erasmus University Medical Center, Dr. Molewaterplein 50, Office NA29-14, PO Box 2040, 3000 CA, Rotterdam, the Netherlands.
3
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus University Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.

Abstract

AIMS/HYPOTHESIS:

In this study, we aimed to examine the association between age at natural menopause and risk of type 2 diabetes, and to assess whether this association is independent of potential mediators.

METHODS:

We included 3639 postmenopausal women from the prospective, population-based Rotterdam Study. Age at natural menopause was self-reported retrospectively and was treated as a continuous variable and in categories (premature, <40 years; early, 40-44 years; normal, 45-55 years; and late menopause, >55 years [reference]). Type 2 diabetes events were diagnosed on the basis of medical records and glucose measurements from Rotterdam Study visits. HRs and 95% CIs were calculated using Cox proportional hazards models, adjusted for confounding factors; in another model, they were additionally adjusted for potential mediators, including obesity, C-reactive protein, glucose and insulin, as well as for levels of total oestradiol and androgens.

RESULTS:

During a median follow-up of 9.2 years, we identified 348 individuals with incident type 2 diabetes. After adjustment for confounders, HRs for type 2 diabetes were 3.7 (95% CI 1.8, 7.5), 2.4 (95% CI 1.3, 4.3) and 1.60 (95% CI 1.0, 2.8) for women with premature, early and normal menopause, respectively, relative to those with late menopause (p trend <0.001). The HR for type 2 diabetes per 1 year older at menopause was 0.96 (95% CI 0.94, 0.98). Further adjustment for BMI, glycaemic traits, metabolic risk factors, C-reactive protein, endogenous sex hormone levels or shared genetic factors did not affect this association.

CONCLUSIONS/INTERPRETATION:

Early onset of natural menopause is an independent marker for type 2 diabetes in postmenopausal women.

KEYWORDS:

Diabetes; Early menopause; Menopause; Type 2 diabetes; Women

PMID:
28721436
DOI:
10.1007/s00125-017-4346-8
[Indexed for MEDLINE]

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