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. 2013 Apr;36(4):1012-9.
doi: 10.2337/dc12-1020. Epub 2012 Dec 10.

Age at menopause, reproductive life span, and type 2 diabetes risk: results from the EPIC-InterAct study

Judith S Brand  1 , Yvonne T van der Schouw, N Charlotte Onland-Moret, Stephen J Sharp, Ken K Ong, Kay-Tee Khaw, Eva Ardanaz, Pilar Amiano, Heiner Boeing, Maria-Dolores Chirlaque, Françoise Clavel-Chapelon, Francesca L Crowe, Blandine de Lauzon-Guillain, Eric J Duell, Guy Fagherazzi, Paul W Franks, Sara Grioni, Leif C Groop, Rudolf Kaaks, Timothy J Key, Peter M Nilsson, Kim Overvad, Domenico Palli, Salvatore Panico, J Ramón Quirós, Olov Rolandsson, Carlotta Sacerdote, María-José Sánchez, Nadia Slimani, Birgit Teucher, Anne Tjonneland, Rosario Tumino, Daphne L van der A, Edith J M Feskens, Claudia Langenberg, Nita G Forouhi, Elio Riboli, Nicholas J Wareham; InterAct Consortium
Affiliations

Age at menopause, reproductive life span, and type 2 diabetes risk: results from the EPIC-InterAct study

Judith S Brand et al. Diabetes Care. 2013 Apr.

Abstract

Objective: Age 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 methods: Data 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.

Results: Mean (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).

Conclusions: Early menopause is associated with a greater risk of type 2 diabetes.

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Figures

Figure 1
Figure 1
Country-specific HRs of type 2 diabetes per SD decrease in menopausal age and reproductive life span: the EPIC-InterAct study. HRs and 95% CIs are derived from Prentice-weighted Cox proportional hazards models adjusted for center, age at entry, diabetes risk factors (BMI, smoking, alcohol consumption, physical activity, and education), and reproductive factors (number of full-term pregnancies, ever oral contraceptive use, and ever HRT use). A: HR of type 2 diabetes per SD decrease in menopausal age. B: HR of type 2 diabetes per SD decrease in reproductive life span. (A high-quality color representation of this figure is available in the online issue.)
See this image and copyright information in PMC

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