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Early menopause linked with type 2 diabetes risk

Early menopause linked with type 2 diabetes risk

Publication date: Saturday, 09 September 2017

Women with early or normal onset menopause are at a higher risk of developing type 2 diabetes (T2D) than those with late onset menopause, according to new research.

The study authors had previously shown that women with early onset of menopause (age <45 years) have an increased risk of cardiovascular disease (CVD) and overall mortality, whereas an onset of menopause at age 50–54 years is linked to a reduced risk of CVD and mortality. While the increased risk is thought to be due to the adverse effects of menopause on CVD risk factors, the influence of age at menopause on these risk factors remains uncertain.

The authors used data from the Rotterdam Study – a population-based, prospective cohort study carried out in the Ommoord district of Rotterdam, the Netherlands. Participants were aged ≥45 and had examinations every 3 to 5 years. Of a total of 6816 participants, 3969 women were included in the present study.
The study showed that of the 3639 women without diabetes at baseline, 348 developed incident T2D over a median follow up of 9.2 years. Compared with women having late menopause (≥55 years), those with the earliest menopause (<40 years) were almost 4 times more likely to have developed T2D; those with menopause at 40–44 years were 2.4 times more likely to develop T2D, whereas those with menopause at 45–55 years were 60% more likely than those with late menopause to develop T2D (Table). Overall, the risk of developing T2D reduced by 4% per year older the woman experienced menopause. Adjustment for the various confounding factors and genetic risk score did not affect the results.

 

Hazard ratio (95% CI)

Premature menopause (<40 years)

3.65 (1.76, 7.55)

Early menopause (40-44 years)

2.36 (1.30, 4.30)

Normal menopause (45-55 years)

1.62 (0.96, 2.76)

Late menopause (>55 years)

Reference

Table: Risks of developing type 2 diabetes with age of natural menopause

ACTION

Early onset of menopause is an independent marker for T2D in postmenopausal women. Future studies are needed to examine the mechanisms behind this association and explore whether timing of natural menopause has any added value in diabetes prediction and prevention. 

Muka T, Assllanaj E, Avazverdi N, et al. Age at natural menopause and risk of type 2 diabetes: a prospective cohort study. Diabetologia 2017; published online link.springer.com/article/10.1007/s00125-017-4346-8

Topics covered:
Category: Evidence in Practice
Edition: Volume 1, Number 1, BJPCN Online 2004

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