Mediatory role of abdominal obesity in the association of early menopause with diabetes among middle-aged and older Chinese women

Abstract

Objective: The aim of this study was to assess the association of early menopause with diabetes and the mediating effect of abdominal obesity. Methods: This cross-sectional study was conducted among 5,693 participants. The data from the second follow-up (2015) of the China Health and Retirement Longitudinal Study were used. Participants self-reported their age at menopause and were divided into three age groups (<45, 45-54, and >54 years) according to the 10th, 10th to 90th, and 90th percentiles, with a menopausal age of 45 to 54 years serving as reference. The total effect was decomposed into direct and indirect (mediating) effects using logistic regression based on the Karlson-Holm-Breen method. Results: Compared to the menopausal age of 45 to 54 years, early menopause (<45 years) was associated with diabetes (odds ratio = 2.19, 95% CI: 1.29-3.69) among Chinese women. The mediating effect of early menopause (<45 years) on diabetes was 4.98% (P = 0.321) for abdominal obesity. Conclusions: Early menopause may be associated with diabetes among Chinese women. Moreover, the mediating effect of abdominal obesity makes up a small percentage and has no statistical significance. Further studies are needed to examine other mechanisms behind the association of early menopause with diabetes.

Associations of age at menarche and age at menopause with diabetes among postmenopausal women in Chongqing, China

“…21 However, other studies have shown that the mediating effect of abdominal obesity has no statistical significance, indicating that early age at menopause may independently affect the risk of diabetes. 40 After interaction analysis, our results can confirm the later study that obesity or abdominal obesity has little effect on the relationship. Studies have found that earlier age at menopause is at higher risk of hypertension, 41 and menopause status is associated with dyslipidemia.…”

“…A prospective study found that women with later age at menopause who were not obese, and women with earlier age at menopause who were obese were more likely to develop diabetes 21 . However, other studies have shown that the mediating effect of abdominal obesity has no statistical significance, indicating that early age at menopause may independently affect the risk of diabetes 40 . After interaction analysis, our results can confirm the later study that obesity or abdominal obesity has little effect on the relationship.…”

Mediation effect of body mass index on the association between age at menopause and type 2 diabetes mellitus in postmenopausal Chinese women

“…Although general and abdominal obesity are both known high-risk factors for T2DM, this study found that a later age at menopause was only associated with total body fat. A recent Chinese study also showed that WC comprised a small percentage and had no statistically significant mediating effect on the association between age at menopause and T2DM 21 . Our study suggested that as Asians are generally leaner than other races, general obesity is more strongly associated with estradiol levels than abdominal obesity in the development of hyperglycemia.…”

“…A recent Chinese study also showed that WC comprised a small percentage and had no statistically significant mediating effect on the association between age at menopause and T2DM. 21 Our study suggested that as Asians are generally leaner than other races, general obesity is more strongly associated with estradiol levels than abdominal obesity in the development of hyperglycemia. Prolonged estradiol accumulation may also contribute to hyperglycemia through inflammatory markers.…”

The Estrogen Component of Menopausal Hormone Therapy as a Preventive Strategy

“…Общая жировая масса у женщин, как правило, на 10-15% больше, чем у мужчин, на протяжении всей жизни с преобладанием жировой ткани в области бедер. Висцеральное ожирение у женщин развивается в период менопаузального перехода и в постменопаузе [13,14].…”