Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study

Donato, Paola Di; Giulini, N. A.; Modena, A. Bacchi; Cicchetti, G; Comitini, Giuseppina; Gentile, G; Cristiani, P.; Careccia, A.; Esposito, E.; Gualdi, F.; Golinelli, Stefania; Bergamini, Ezio; Masellis, G; Rastelli, Stefania; Gigli, C; Elía, Andrés; Marchesoni, D.; Sticotti, F; Frate, G. Del; Zompicchiatti, C; Marino, Luise V.; Costa, Mauro; Pinto, P.; Dodero, D; A, Storace; Spinelli, Gian Paolo; Quaranta, Sylvie; Bossi, C. M.; Ollago, A; Omodei, U.; Vaccari, M.; Luerti, Massimo; Repetti, F.; Zandonini, G.; Raspagliesi, Francesco; Dolci, Filippo; Gambarino, G.; Pasquale, B De; Polizzotti, G.; Borsellino, Giovanni; Alpinelli, P; Natale, Nicola; Colombo, Delia; Belloni, C; Viani, A; Cecchini, Giulio; Vinci, G W; Samaja, B. A.; Pasinetti, E.; Penotti, M.; Ognissanti, F; Pesando, P; Malanetto, C; Gallo, Maria Eugênia Novinsk; Dolfin, G; Tartaglino, P.; Mossotto, D.; Pistoni, A; Tarani, A; Rattazzi, P. D.; Rossaro, D.; Campanella, Michelangelo; Arisi, E.; Gamper, Marianne; Salvatores, D.; Bocchin, E.; Stellin, G.; Meli, G; Azzini, V.; Tirozzi, F.; Buoso, G.; Fraioli, Rebecca E.; Marsoni, V.; Cetera, C.; Sposetti, R.; Candiotto, E.; Pignalosa, R; Pup, Lino Del; Bellati, U; Angeloni, Claudio; Buonerba, M.; Garzarelli, S.; Santilli, C.; Mucci, M.; Nisio, Q. Di; Cappa, F; Pierangeli, I.; Cordone, Annalisa; Falasca, L.; Ferrante, Daniel; Serra, G. B.; Cirese, E.; Todaro, P. A.; Romanini, C; Spagnuolo, Lorenzo; Lanzone, Antonio; Donadio, Carlo; Fabiani, Massimo; Baldaccini, E.; Votano, Sergio; Bellardini, P.; Favale, W; Monti, Veronica; Bonomo, Adriana; Boninfante, C E; Pietrobattista, P; Massacesi, Luca; Donini, G; Savio, F Del; Palombi, Leonardo; Procaccioli, P; Romani, Arianna; Romagnoli, G F; Genazzani, Andrea Riccardo; Gambacciani, Marco; Scarselli, Gianfranco; Curiel, P; Leo, Vincenzo De; Melani, Andrea S.; D'Ancona, V Levi; Giarrè, Giovanna; Gioia, E. Di; Ceccarelli, P. L.; Massi, G. b.; Cosci, S; Gacci, G; Cascianini, A; Sarti, Costante Donati; Bircolotti, S; Pupita, P.; Mincigrucci, M; Spadafora, Andrea; Santeufemia, G; Marongiu, G; Lai, Guan-Jhih; Lai, RenKui; Dessole, Salvatore; D’Andrea, Settimio; Coppola,; Chiàntera, A; Placido, De; Arienzo, R; Pastore, A R; Tamburrino, Anna; Cardone, Antonio; Colacurci, Nicola; Izzo, Stefano; Tesauro, R; Pascarella, A; Silvio, M G De; Prisco, L. Di; Lauda, N; Sirimarco, Fabio; Agrimi, C; Casarella, G; Senatore, G; Ronzini, S; G, Ruccia; Carlo, Giulia De; Pisaturo, G; Carlomagno, Francesca; Fasolino, Antonio; Fiorillo, F.; Sorrentino, R.; Ercolano, Vb; Panariello, S; Brún, Aoife De; Tropea, Pier Francesco; Stigliano, Cm; Amoroso, A; Vadala, P.; Coco, A.; Galati, Giovanni; Barese, G; Masciari, G; Pirillo, Paola; Gioffrè, T; Mastrantonio, P; Cardamone, Antonio; D'Angelo, Nicholas; Valentino, Giovanna; Barretta, R; Ferraro, Gaetana; Ferruccio, C; Agostinelli, Daniela; Corrado, Giovanni; Scopelliti, Annalisa; Schönauer, S; Trojano, Vito; Bongiovanni, F; Tinelli, F G; Poddi, E R; Scarpello, F; Colonna, Laura; G, Fischetti; Dória, Renata Gebara Sampaio; Trombetta, Giselle Benvenutti; Cocca, E B; D’Amore, Anna; Masi, M Di; Liguori, Rosario; Dimaggio, A; Laneve, Mario; Maolo, M C; Gravina, Giovanni Luca; Nacci, Gianfranco Giocoli; Nocera, Fabio Di; Lupo, A; Giannola, C; Graziano, R; Mezzatesta, M; Vegna, G; Giannone, Germana; Palumbo, Gaetana; Cancellieri, Francesco; Mondo, Alessandro; Cordopatri, A.; Carrubba, M; Mazzola, Vittoria; Cincotta, L; D'Asta, S; Bono, A.; Calsi, L Li; Nigro, S Cavallaro; Schiliro, S; Repici, Alessandro; Gullo, Damiano; Orlando, Antonina; Specchiale, F; Papotto, A...Less; Abruzzo,; Basilicata,; Calabria,; Campania,; Emilia,; Romagna,; Giulia, Friuli Venezia; Lazio, None; Liguria,; Lombardia,; Marche,; Molise,; Piemonte, Paolo; Puglia,; Sardegna, None; Sicilia,; Toscana,; Adige, Trentino Alto; Umbria,; D'Aosta, Valle; Veneto,; Massacesi, A; Aloysio, P De; Campagnoli, C; Gambacciani, Andrea; Graziottin, Alessandra; Baldi, C.; Tonti, G.; Parazzini, Fabio; Chatenoud, L; Italia, Gruppo di Studio Progetto Menopausa

doi:10.1080/13697130500196866

Cited by 42 publications

(13 citation statements)

References 14 publications

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“…Previous results regarding menopausal age are mixed (12–14). In a large study among women entering menopause clinics, no association between menopausal age and type 2 diabetes was found (13). In another cross-sectional study, diabetes was more prevalent among women with premature menopause, but this association was not statistically significant after multivariable adjustment (14).…”

Section: Discussionmentioning

confidence: 99%

“…Oophorectomized women seem to have less favorable glucose and insulin levels (10,11), which is suggestive of a link between premature menopause and diabetes risk. However, the few epidemiological studies that have investigated the relationship between menopausal age and diabetes yielded conflicting results with either an inverse (12) or no (13,14) association. Thus far, no prospective studies have been performed, and no studies have examined the relationship with reproductive life span (defined as menopausal age minus menarcheal age), which is a marker of total duration of endogenous estrogen exposure.…”

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confidence: 99%

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Age at Menopause, Reproductive Life Span, and Type 2 Diabetes Risk

et al. 2013

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OBJECTIVEAge at menopause is an important determinant of future health outcomes, but little is known about its relationship with type 2 diabetes. We examined the associations of menopausal age and reproductive life span (menopausal age minus menarcheal age) with diabetes risk.RESEARCH DESIGN AND METHODSData were obtained from the InterAct study, a prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition. A total of 3,691 postmenopausal type 2 diabetic case subjects and 4,408 subcohort members were included in the analysis, with a median follow-up of 11 years. Prentice weighted Cox proportional hazards models were adjusted for age, known risk factors for diabetes, and reproductive factors, and effect modification by BMI, waist circumference, and smoking was studied.RESULTSMean (SD) age of the subcohort was 59.2 (5.8) years. After multivariable adjustment, hazard ratios (HRs) of type 2 diabetes were 1.32 (95% CI 1.04–1.69), 1.09 (0.90–1.31), 0.97 (0.86–1.10), and 0.85 (0.70–1.03) for women with menopause at ages <40, 40–44, 45–49, and ≥55 years, respectively, relative to those with menopause at age 50–54 years. The HR per SD younger age at menopause was 1.08 (1.02–1.14). Similarly, a shorter reproductive life span was associated with a higher diabetes risk (HR per SD lower reproductive life span 1.06 [1.01–1.12]). No effect modification by BMI, waist circumference, or smoking was observed (P interaction all > 0.05).CONCLUSIONSEarly menopause is associated with a greater risk of type 2 diabetes.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Age at Menopause, Reproductive Life Span, and Type 2 Diabetes Risk

et al. 2013

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“…Only one study quantified VAT in overweight and obese women to assess mechanistic links between CRF and metabolism (25). Yet, obese women are prone to develop metabolic disease (20,31). Given the discrepancy among studies, we suggest that VAT may not be the crucial factor linking CRF and metabolism.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory Fitness and Insulin Sensitivity in Overweight or Obese Subjects May Be Linked Through Intrahepatic Lipid Content

Haufe

Engeli²,

Budziarek³

et al. 2010

Diabetes

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OBJECTIVELow cardiorespiratory fitness (CRF) predisposes one to cardiovascular disease and type 2 diabetes in part independently of body weight. Given the close relationship between intrahepatic lipid content (IHL) and insulin sensitivity, we hypothesized that the direct relationship between fitness and insulin sensitivity may be explained by IHL.RESEARCH DESIGN AND METHODSWe included 138 overweight to obese, otherwise healthy subjects (aged 43.6 ± 8.9 years, BMI 33.8 ± 4 kg/m2). Body composition was estimated by bioimpedance analyses. Abdominal fat distribution, intramyocellular, and IHL were assessed by magnetic resonance spectroscopy and tomography. Incremental exercise testing was performed to estimate an individual's CRF. Insulin sensitivity was determined during an oral glucose tolerance test.RESULTSFor all subjects, CRF was related to insulin sensitivity (r = 0.32, P < 0.05), IHL (r = −0.27, P < 0.05), and visceral (r = −0.25, P < 0.05) and total fat mass (r = −0.32, P < 0.05), but not to intramyocellular lipids (r = −0.08, NS). Insulin sensitivity correlated significantly with all fat depots. In multivariate regression analyses, independent predictors of insulin sensitivity were IHL, visceral fat, and fitness (r2 = −0.43, P < 0.01, r2 = −0.34, and r2 = 0.29, P < 0.05, respectively). However, the positive correlation between fitness and insulin sensitivity was abolished after adjustment for IHL (r = 0.16, NS), whereas it remained significant when adjusted for visceral or total body fat. Further, when subjects were grouped into high versus low IHL, insulin sensitivity was higher in those subjects with low IHL, irrespective of fitness levels.CONCLUSIONSOur study suggests that the positive effect of increased CRF on insulin sensitivity in overweight to obese subjects may be mediated indirectly through IHL reduction.

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“…Although the association of menopausal status and hyperglycemia has been investigated ( 4 – 12 ), findings about whether the postmenopausal state would influence hyperglycemia independently of normal aging remain controversial. Two cohort studies with a large number of female participants investigated the impact of the postmenopausal state on diabetes compared with the premenopausal state ( 13 , 14 ). A study of 22,426 Japanese women suggested that there is no significant association between the postmenopausal state and diabetes when adjustment is made for chronological age ( 14 ).…”

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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)

et al. 2013

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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.

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Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study

Cited by 42 publications

References 14 publications

Age at Menopause, Reproductive Life Span, and Type 2 Diabetes Risk

Age at Menopause, Reproductive Life Span, and Type 2 Diabetes Risk

Cardiorespiratory Fitness and Insulin Sensitivity in Overweight or Obese Subjects May Be Linked Through Intrahepatic Lipid Content

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)

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