Chung, H.-F., Dobson, A.J., Hayashi, K. et al. (13 more authors) (2023) Ethnic differences in the association between age at natural menopause and risk of type 2 diabetes mellitus among postmenopausal women: a pooled analysis of individual data from 13 cohort studies. Diabetes Care, 46 (11). pp. 2024-2034. ISSN 0149-5992
Abstract
OBJECTIVE
To investigate associations between age at natural menopause, particularly premature ovarian insufficiency (POI; natural menopause before age 40 years), and incident type 2 diabetes (T2D) and identify any variations by ethnicity.
RESEARCH DESIGN AND METHODS
We pooled individual-level data of 338,059 women from 13 cohort studies without T2D before menopause from six ethnic groups: White (n = 177,674), Chinese (n = 146,008), Japanese (n = 9,061), South/Southeast Asian (n = 2,228), Black (n = 1,838), and mixed/other (n = 1,250). Hazard ratios (HRs) of T2D associated with age at menopause were estimated in the overall sample and by ethnicity, with study as a random effect. For each ethnic group, we further stratified the association by birth year, education level, and BMI.
RESULTS
Over 9 years of follow-up, 20,064 (5.9%) women developed T2D. Overall, POI (vs. menopause at age 50–51 years) was associated with an increased risk of T2D (HR 1.31; 95% CI 1.20–1.44), and there was an interaction between age at menopause and ethnicity (P < 0.0001). T2D risk associated with POI was higher in White (1.53; 1.36–1.73), Japanese (4.04; 1.97–8.27), and Chinese women born in 1950 or later (2.79; 2.11–3.70); although less precise, the risk estimates were consistent in women of South/Southeast Asian (1.46; 0.89–2.40), Black (1.72; 0.95–3.12), and mixed/other (2.16; 0.83–5.57) ethnic groups. A similar pattern, but with a smaller increased risk of T2D, was observed with early menopause overall (1.16; 1.10–1.23) and for White, Japanese, and Chinese women born in 1950 or later.
CONCLUSIONS
POI and early menopause are risk factors for T2D in postmenopausal women, with considerable variation across ethnic groups, and may need to be considered in risk assessments of T2D among women.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 by the American Diabetes Association. This is an author produced version of an article published in Diabetes Care. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 25 Aug 2023 11:34 |
Last Modified: | 19 Nov 2024 14:09 |
Status: | Published |
Publisher: | American Diabetes Association |
Identification Number: | 10.2337/dc23-1209 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:202723 |