medwireNews: Women who experience menopause at a younger age have a higher risk for type 2 diabetes than those with later onset of menopause, study results suggest.
In an analysis of data from the population-based Rotterdam study, Taulant Muka (Erasmus University Medical Center, Rotterdam, the Netherlands) and study co-authors found that 348 of 3639 postmenopausal women without diabetes at baseline developed type 2 diabetes over a median 9.2 years of follow-up.
After adjustment for variables including age at menarche, use of hormone therapy, and number of pregnancies, women who experienced natural menopause before 40 years of age were 3.65 times as likely to develop type 2 diabetes as those who were aged over 55 years at the onset of menopause.
And participants who reached menopause at the ages of 40–44 and 45–55 years had a 2.36- and 1.62-fold increased risk for type 2 diabetes, respectively, compared with women who entered menopause after 55 years of age.
The associations remained consistent after further adjustment for factors including body mass index, glycemic traits, and cardiovascular disease, and in sensitivity analyses adjusting for levels of serum thyroid-stimulating hormone, estradiol, other endogenous sex hormones, and sex hormone-binding globulin.
These findings extend the results of previous studies by showing that the association between early onset of natural menopause and type 2 diabetes risk is “independent of potential mediators, including endogenous sex hormone levels,” say the researchers in Diabetologia.
They suggest that a possible explanation for the association “could be disruption of the hypothalamus–pituitary–ovarian axis, resulting in increased release of the gonadotropins and follicle-stimulating hormone [FSH] by the pituitary gland,” but note that the study did not include data on levels of FSH.
Muka and colleagues also caution that their investigation was limited by “reliance on retrospective self-reporting of age at natural menopause, which is subject to faulty memory and reporting bias, particularly in older women,” and that all confounding factors “were assessed years after menopause and not at the start of menopause.”
And they conclude that future research should “examine the mechanisms behind this association and explore whether the timing of natural menopause can add value to diabetes prediction and prevention.”
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