Effect of Postmenopausal Status and Age at Menopause on Type 2 Diabetes and Prediabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 17 (TOPICS 17)

Abstract

OBJECTIVEFindings on the effect of menopause or age at menopause on the presence of hyperglycemia are controversial, and why women after menopause have a higher probability of having hyperglycemia than men in the same age range remains unknown.RESEARCH DESIGN AND METHODSWe reviewed data on 29,189 men, 6,308 premenopausal women, and 4,570 postmenopausal women in Japan. Odds ratios (ORs) for diabetes or prediabetes indicated by American Diabetes Association criteria were calculated for men and for pre- and postmenopausal women.RESULTSCompared with premenopausal women, women after natural menopause had an age-adjusted OR of 1.40 (95% CI 1.03–1.89) for diabetes, and women after menopause by surgical or other causes had an age-adjusted OR of 1.59 (1.07–2.37). The age-adjusted OR in men was 4.02 (3.15–5.14). Compared with premenopausal nondiabetic women, postmenopausal nondiabetic women had a significantly elevated OR of 1.33 (1.20–1.48) for prediabetes; nondiabetic men had an OR of 1.93 (1.77–2.10) independently of age and demographic and metabolic factors. Even among women aged <50 years, postmenopausal status was significantly associated with an elevated OR (1.50 [1.18–1.91]) for dysglycemia (either diabetes or prediabetes). Postmenopausal women aged ≥50 years had a particularly elevated OR for dysglycemia, regardless of age at menopause.CONCLUSIONSThe postmenopausal state was significantly associated with the presence of dysglycemia independently of normal aging, although the increased probability in postmenopausal women did not equal that in men. Among women, menopause and older age might additively influence the elevated probability of dysglycemia.

Response to Comment on Heianza et al. Effect of Postmenopausal Status and Age at Menopause on Type 2 Diabetes and Prediabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 17 (TOPICS 17). Diabetes Care 2013;36:4007–4014

“…The first conclusion of our study was that the postmenopausal state was significantly associated with dysglycemia independently of normal aging, although the increased probability in postmenopausal women did not equal that in men (2). We mentioned that the prevalence of diabetes was reported to be lower in women than in men aged 60 years or younger, whereas women in their 60s and 70s were more likely to have diabetes than men of the same age based on data from the International Diabetes Federation and a study from China (3).…”

“…We thank Akter et al (1) for their interest in our study (2). While we agree that the mean age was higher in the postmenopausal women than in the premenopausal women, results of our additional analysis of the 10,878 women showed that independently of older age ($50 years) and demographic and metabolic factors (BMI, parental history of diabetes, physical activity habit, smoking habit, hypertension, log-transformed triglycerides, and HDL cholesterol) the postmenopausal state was associated with a 1.50 (95% CI 1.30-1.74) higher probability of the presence of dysglycemia (either type 2 diabetes or prediabetes) compared with premenopausal women.…”

“…Data from the survey in Japan also indicated that the probability of diabetes among women was particularly elevated after the age of 60 years, but it is difficult to directly compare the prevalence rate of diabetes in our study to that of other reports. As our results were based on a cross-sectional analysis (2), further prospective studies should examine whether menopause itself would be an independent risk factor for the development of future type 2 diabetes.…”

Comment on Heianza et al. Effect of Postmenopausal Status and Age at Menopause on Type 2 Diabetes and Prediabetes in Japanese Individuals: Toranomon Hospital Health Management Center Study 17 (TOPICS 17). Diabetes Care 2013;36:4007–4014

“…We read with great interest the article by Heianza et al (1), which showed a higher probability of type 2 diabetes and prediabetes among postmenopausal women than among premenopausal women. It is also suggested that menopause and older age might additively influence the elevated probability of type 2 diabetes.…”

“…We hope this article provides additional clarification regarding the ultimate goals of Heianza et al (1) and calls for further studies looking into whether menopausal status independently influences diabetes risk.…”