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

Meng Wang,Yu Guo,Ling Yang,Liming Li,Min Yu,Jun Lv,Wei Gan,Christiana Kartsonaki,Zhengming Chen

doi:10.1186/s12986-022-00643-x

Abstract

BackgroundMenopause 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.MethodsWe 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.ResultsOverall, 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.ConclusionsIn 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.

Highlights

Menopause characteristics have been implicated in future health consequences, yet little is known about its relevance to diabetes
The post-menopausal status coincided with increased risks for multiple chronic conditions among women [7], and findings suggested that the earlier and later age at menopause was associated with higher risk of cardiovascular diseases [8] and cancers [9, 10], respectively
Based on nearly 300,000 middle-aged women from 10 diverse regions in China, we found that naturally peri, or post-menopausal women had significantly increased risk of developing diabetes compared with pre-menopausal women of the same age, after adjustment for potential confounders

Summary

Introduction

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. Within Chinese populations, epidemiological evidence further indicated higher diabetes prevalence and related mortality among women than men in their 60 s or older [4,5,6], which highlighted the necessity to better investigate the extra risk factors in these susceptible groups. The post-menopausal status coincided with increased risks for multiple chronic conditions among women [7], and findings suggested that the earlier and later age at menopause was associated with higher risk of cardiovascular diseases [8] and cancers (e.g., breast and endometrium cancer) [9, 10], respectively

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