Gonadal hormonal factors before menopause and incident type 2 diabetes in women: A 22‐year follow‐up of 83 799 women from the <scp>E3N</scp> cohort study

Tatulashvili, Sopio; Gusto, Gaëlle; Cosson, E.; Balkau, Beverley; Gourdy, Pierre; Bonnet, Fabrice; Bihan, H.; Fagherazzi, Guy

doi:10.1111/1753-0407.13129

Cited by 6 publications

(4 citation statements)

References 43 publications

(63 reference statements)

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“…In both cross-sectional [ 16 ] and longitudinal studies [ 17 , 18 ], earlier menopause was found to be associated with increased odds of diabetes. Recent cohort studies also reinforced the inverse association with observations that later menopause was associated with lower risk of diabetes [ 19 , 20 ]. However, in contrast, some authors reported that women who had later menopause experience were more likely to have diabetes [ 12 , 21 ].…”

Section: Introductionmentioning

confidence: 73%

Menopausal status, age at natural menopause and risk of diabetes in China: a 10-year prospective study of 300,000 women

et al. 2022

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Background Menopause characteristics have been implicated in future health consequences, yet little is known about its relevance to diabetes. We examined the associations of menopausal status and age at natural menopause with diabetes risk in Chinese women. Methods We used prospective data of the China Kadoorie Biobank study that recruited 302,522 women aged 30–79 years in 2004–2008 from 10 areas across China. During average 10.8 years of follow-up, 11,459 incident diabetes cases were recorded among 281,319 women without prior diabetes diagnosis at baseline. Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for incident diabetes associated with menopausal status and age at natural menopause. Results Overall, the mean (SD) age at natural menopause was 48.2 (4.4) years among 141,789 post-menopausal women. Naturally peri-, or post-menopausal women were at higher risk of diabetes, with HRs of 1.17 (95% CI 1.06–1.29) and 1.15 (1.06–1.25) compared with pre-menopausal women, adjusting for several potential confounders. Among women who had natural menopause, the HR of diabetes was 1.14 (1.01–1.30), 1.01 (0.93–1.09), 1.10 (1.04–1.16), and 1.10 (1.01–1.20) for menopause at ages less than 40, 40–44, 50–53, and 54 years or older, respectively, relative to 45–49 years. Conclusions In this study, we found that women with naturally peri-, or post-menopausal status had higher risk of developing diabetes. Besides, among the post-menopausal women, both earlier and later age at natural menopause were associated with increased risk of diabetes.

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Section: Introductionmentioning

confidence: 73%

Menopausal status, age at natural menopause and risk of diabetes in China: a 10-year prospective study of 300,000 women

et al. 2022

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“…On the other hand, chronic hyperglycemia of early onset T2DM and type 1 diabetes mellitus (T1DM), which is commonly presented at younger age, accelerate ovarian ageing. In the French prospective cohort study (83,799 women, 22 years of follow-up), later age at menopause was related to reduced T2DM risk [ 24 , 25 ]. A prospective analysis of the Women’s Health Initiative (WHI) data ( n = 124,379) showed that women with shorter (< 30 years) and longer (> 45 years) reproductive lifespan had an increased risk of T2DM (37% and 23%, respectively) [ 26 ].…”

Section: Menopausal Age and T2dmmentioning

confidence: 99%

Menopausal Hormone Therapy in Women with Type 2 Diabetes Mellitus: An Updated Review

Paschou,

Athanasiadou,

Papanas

2024

Diabetes Ther

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Menopause is accompanied by several metabolic adaptations, which are related to insulin resistance, increased total body fat mass, and central abdominal fat accumulation, predisposing women to type 2 diabetes mellitus (T2DM) development. Metabolic syndrome has a high prevalence in postmenopausal women, indicating the loss of estrogen protection on metabolic and cardiovascular health. Moreover, earlier age at menopause has been related to increased risk of T2DM. Menopausal hormone therapy (MHT) has favorable results in glucose metabolism. Indeed, it reduces the risk of T2DM in women without this condition and improves glycemic control in women with T2DM. Before MHT initiation in women with clinical indications, it is imperative to assess their cardiovascular disease (CVD) risk, using official electronic algorithms for score calculation. The latter will determine regimen, dose, and administration route of MHT. Oral estrogens are preferable in women with low CVD risk, while transdermal administration is indicated in those with moderate and high CVD risk, as the risk of stroke and venous thromboembolism (VTE) is increased with oral administration. Oral 17β-estradiol is usually preferred in women with T2DM, as this route has more beneficial effects on glucose metabolism. Oral estrogens are also suggested in perimenopausal or recently postmenopausal women with low CVD risk. Although oral estrogens have favorable effects when indicated, the risk of VTE or stroke should always be considered. Micronized progesterone, dydrogesterone, and transdermal norethisterone are the progestogens used in postmenopausal women with T2DM and intact uterus. MHT should not be initiated in women > 60 years or > 10 years in menopause, as there is an increased thromboembolic risk in women with established atherosclerosis and no additional cardiovascular benefit in women without atherosclerosis. In conclusion, MHT administration in postmenopausal women with T2DM can be safe and effective as long as the therapeutic regimen has been properly selected according to their cardiovascular, metabolic, and fracture risk.

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“…Type 2 diabetes mellitus (T2DM) is one of the primary causes of death and CVDs in the world ( 95 ). At present, the correlation between ANM and T2DM is controversial ( 96 – 99 ). The inconsistencies in the results are possibly caused by variations in variable adjustment, ethnicity diversity in the sample population, or genetic traits.…”

Section: Anm As An Exposurementioning

confidence: 99%

Review of mendelian randomization studies on age at natural menopause

Zhang,

Huangfu,

Wang

2023

Front. Endocrinol.

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Menopause marks the end of the reproductive phase of life. Based on epidemiological studies, abnormal age at natural menopause (ANM) is thought to contribute to a number of adverse outcomes, such as osteoporosis, cardiovascular disease, and cancer. However, the causality of these associations remains unclear. A powerful epidemiological method known as Mendelian randomization (MR) can be used to clarify the causality between ANM and other diseases or traits. The present review describes MR studies that included ANM as an exposure, outcome and mediator. The findings of MR analyses on ANM have revealed that higher body mass index, poor educational level, early age at menarche, early age at first live birth, early age at first sexual intercourse, and autoimmune thyroid disease appear to be involved in early ANM etiology. The etiology of late ANM appears to be influenced by higher free thyroxine 4 and methylene tetrahydrofolate reductase gene mutations. Furthermore, early ANM has been found to be causally associated with an increased risk of osteoporosis, fracture, type 2 diabetes mellitus, glycosylated hemoglobin, and the homeostasis model of insulin resistance level. In addition, late ANM has been found to be causally associated with an increased systolic blood pressure, higher risk of breast cancer, endometrial cancer, endometrioid ovarian carcinoma, lung cancer, longevity, airflow obstruction, and lower risk of Parkinson’s disease. ANM is also a mediator for breast cancer caused by birth weight and childhood body size. However, due to the different instrumental variables used, some results of studies are inconsistent. Future studies with more valid genetic variants are needed for traits with discrepancies between MRs or between MR and other types of epidemiological studies.

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Gonadal hormonal factors before menopause and incident type 2 diabetes in women: A 22‐year follow‐up of 83 799 women from the E3N cohort study

Cited by 6 publications

References 43 publications

Menopausal status, age at natural menopause and risk of diabetes in China: a 10-year prospective study of 300,000 women

Menopausal status, age at natural menopause and risk of diabetes in China: a 10-year prospective study of 300,000 women

Menopausal Hormone Therapy in Women with Type 2 Diabetes Mellitus: An Updated Review

Review of mendelian randomization studies on age at natural menopause

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