Age at natural menopause and risk of diabetes in adult women: Findings from the China Kadoorie Biobank study in the Zhejiang area

Abstract

Aims/IntroductionThere has been considerable professional debate on the association between age at menopause and diabetes risk, while the findings are controversial. The present study explored the association between late menopause and the prevalence of diabetes in the Chinese population.Material and MethodsThe data were part of the baseline survey of China Kadoorie Biobank from Zhejiang Province. A total of 17,076 postmenopausal women were included in the present study. Logistic regression models were used to calculate the adjusted odds ratios and their 95% confidence intervals.ResultsOf the participating women, 1,288 (7.54%) had type 2 diabetes. In comparison with those with menopause at 46–52 years, women with menopause at a later age (≥53 years) were 1.21‐fold (95% confidence interval 1.03–1.43) more likely to have diabetes.ConclusionsThe present findings suggested that later age at menopause was associated with an increased prevalence of diabetes.

Early menopause and premature ovarian insufficiency are associated with increased risk of type 2 diabetes: a systematic review and meta-analysis

“…Women with EM displayed a higher risk of developing T2DM compared with women with normal menopausal age (>45 years) including also those with late menopausal age (12 studies, four prospective cohorts) (11,12,13,14,18,19,21,22,23,24,25,26) (OR: 1.12, 95% CI: 1.01-1.23, P = 0.019; I 2 : 65.69%, P < 0.001). One study did not provide absolute number of participants in both T2DM and non-T2DM groups and, therefore, OR was directly included in the analysis (20) (Fig.…”

“…Of those, six articles were excluded, due to the following reasons: (i) No data on T2DM according to menopausal age (n = 1); (ii) No data on EM (n = 3); (iii) Non-English language (n = 1); (iv) Referral to another paper already included in the analysis (n = 1). Thirteen studies were included in the qualitative and quantitative analysis (11,12,13,14,18,19,20,21,22,23,24,25,26). The excluded studies and the reasons for their exclusion are available in Supplementary Table 3.…”

“…Diagnosis of T2DM was set by various methods. Fasting plasma glucose (FPG) ≥126 mg/dL (7 mmol/L) or glycated hemoglobin (HbA 1c ) ≥6.5% or plasma glucose ≥200 mg/dL (11.1 mmol/L) at 2 h, after an oral glucose tolerance test (OGTT) were used in eight studies (12,14,18,21,22,24,25,26). Of note, in one study OGTT was performed with a glucometer (20) and in another study the method of T2DM diagnosis was not defined (13).…”

“…In the remaining studies, the diagnosis was derived from self-reports, health care reports, hospital admissions or history of anti-diabetic medication use (11,19,23). With respect to the type of menopause, five studies included only women with natural menopause (12,13,24,25,26), five included mixed populations (9-39% of which with surgical menopause) (11,14,18,19,23) and in three studies (20,21,22) the type of menopause was not clearly defined. No data on prediabetes (defined either as 'impaired fasting glucose' or 'impaired glucose tolerance') were available.…”

Screening for chronic conditions with reproductive factors using a machine learning based approach

“…A Japanese study also found a similar relationship regarding hypercholesterolemia 21 . Furthermore, the China Kadoorie Biobank study reported that Chinese women with late menopause (≥53 years) were 1.21 (95% CI: 1.03-1.42) times more likely to have T2DM than women with menopause at 46-52 years old (p < 0.0001) 22 . Another Chinese study also found that a higher number of live births was associated with hypertension and DM, and mediated by lifestyle and dyslipidemia 23 .…”