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

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 Rotterda...

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Published in:Diabetologia Vol. 60; no. 10; pp. 1951 - 1960
Main Authors: Muka, Taulant, Asllanaj, Eralda, Avazverdi, Naim, Jaspers, Loes, Stringa, Najada, Milic, Jelena, Ligthart, Symen, Ikram, M. Arfan, Laven, Joop S. E., Kavousi, Maryam, Dehghan, Abbas, Franco, Oscar H.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.10.2017
Springer Nature B.V
Subjects:
Adult
Age
Age Factors
Androgens
C-reactive protein
Cohort analysis
Diabetes
Diabetes mellitus
Diabetes Mellitus, Type 2 - epidemiology
Female
Genetic factors
Health risk assessment
Hormone replacement therapy
Human Physiology
Humans
Incidence
Insulin
Internal Medicine
Medical records
Medicine
Medicine & Public Health
Menopause
Metabolic Diseases
Middle Aged
Population studies
Post-menopause
Postmenopause
Prospective Studies
Risk
Risk factors
Womens health
Type 2 diabetes
Women
Diabetes
Menopause
Early menopause
ISSN:0012-186X, 1432-0428, 1432-0428
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Summary: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.
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ISSN:0012-186X
1432-0428
1432-0428
DOI:10.1007/s00125-017-4346-8