Association between endometriosis and risk of type 2 diabetes: Results from the prospective E3N cohort.

Abstract

Several studies suggest an association between endometriosis and the risk of cardio-metabolic diseases. This study aimed to prospectively evaluate the association between history of endometriosis and incident type 2 diabetes. E3N is a prospective cohort of 98,995 French women aged 40-65years at inclusion. Multivariable Cox regression models were used to estimate hazard ratios and 95% confidence intervals for the association between endometriosis and incident type 2 diabetes. We evaluated effect modification by age, body mass index, infertility treatment, adherence to the Mediterranean diet, and menopausal status. Age at inclusion was 51±6years and there were 2672 incident cases of type 2 diabetes. A total of 4606 women reported surgically-confirmed endometriosis among 83,582 women with no history of diabetes at inclusion. Endometriosis was not associated with type 2 diabetes risk in a model adjusted for age, BMI, physical activity, smoking, education, age at menarche and oral contraceptive use (hazard ratio [HR]=1.09; 95% confidence interval [CI]=0.92-1.29), neither after further adjustment for family history of diabetes, hypertension and menopausal status (HR=0.97;95%CI=0.80-1.16). The relationship did not differ by age at inclusion, BMI, infertility treatment, diet or menopausal status (p>0.05). Surgically-confirmed endometriosis was not associated with the risk of type 2 diabetes in this large cohort, confirming that endometriosis is not a risk marker for type 2 diabetes.