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Ren and colleagues have undertaken a cross-sectional study of 8191 women (median age 56 years, interquartile range 47–65 years) recruited in rural China to determine the association between menopause and the likelihood of developing type 2 diabetes (T2D) [1]. The diagnosis of T2D in women was established by a fasting plasma glucose of 7.0 mmol/l or greater, and/or the use of insulin or an oral hypoglycemic agent and/or a self-reported history of diabetes (excluding type 1 diabetes, gestational diabetes mellitus, or diabetes due to other causes).

Of note, 38% of the women in the study were overweight, 22% were obese and 30% had hypertension. Only 7.8% reported a family history of T2D.

The study reported an overall prevalence of T2D of 13% amongst the included women. After adjusting for age, smoking, alcohol drinking, body mass index (BMI), age at menarche, systolic and diastolic blood pressures, and family history of diabetes, the risk of T2D was greater for women who were postmenopausal versus premenopausal women (adjusted odds ratio (AOR) 1.90, 95% CI 1.51–2.37). The strongest association between T2D and menopause in the adjusted model was for normal weight women (a BMI < 24 kg/m2), such that postmenopausal normal-weight women had a more than three-fold risk of having T2D versus premenopausal women (AOR 3.35, 95% CI 1.98–5.32). Age was a mediating factor in the apparent effect of menopause, but an effect of menopause persisted despite adjustment for age.

Author(s)

  • Susan R. Davis
    Professor of Women’s Health and NHMRC Senior Principal Research Fellow, Director, Women’s Health Research Program, President, International Menopause Society; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University Australia

Citations

  1. Ren Y, Zhang M, Liu Y, et al. Association of menopause and type 2 diabetes mellitus. Menopause 2018 Aug 20. Epub ahead of print
    http://www.ncbi.nlm.nih.gov/pubmed/30130291
  2. Jones ME, Thorburn AW, Britt KL, et al. Aromatase-deficient (ArKO) mice accumulate excess adipose tissue. J Steroid Biochem Mol Biol 2001;79:3-9
    http://www.ncbi.nlm.nih.gov/pubmed/11850201
  3. Davis SR, Castelo-Branco C, Chedraui P, et al. Understanding weight gain at menopause. Climacteric 2012;15:419-29
    http://www.ncbi.nlm.nih.gov/pubmed/22978257
  4. Yki-Jarvinen H. Sex and insulin sensitivity. Metabolism 1984;33:1011-15
    http://www.ncbi.nlm.nih.gov/pubmed/6387364
  5. Hevener AL, Zhou Z, Moore TM, Drew BG, Ribas V. The impact of ERalpha action on muscle metabolism and insulin sensitivity – Strong enough for a man, made for a woman. Mol Metab 2018;15:20-34
    http://www.ncbi.nlm.nih.gov/pubmed/30005878
  6. Mandrup CM, Egelund J, Nyberg M, et al. Effects of menopause and high-intensity training on insulin sensitivity and muscle metabolism. Menopause 2018;25:165-75
    http://www.ncbi.nlm.nih.gov/pubmed/28953212
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