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

Judith S. Brand, 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. KeyPeter 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

*Corresponding author for this work

Research output: Contribution to journalArticleResearchpeer-review

184 Citations (Scopus)

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 atmenopause 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.

Original languageEnglish
Pages (from-to)1012-1019
Number of pages8
JournalDiabetes Care
Volume36
Issue number4
DOIs
Publication statusPublished - Apr 2013
Externally publishedYes

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