Department of Epidemiology and Biostatistics, School of Public Health, Capital Medical University, Beijing, China.
Department of Endocrinology, Chinese People's Liberation Army General Hospital, Beijing, China.
J Clin Endocrinol Metab. 2019 Jul 1;104(7):3039-3048. doi: 10.1210/jc.2018-02310.
The relationship between age at natural menopause and type 2 diabetes mellitus (T2DM) has yielded conflicting results, particularly when confounded by the presence of obesity. We therefore aimed to examine the association between age at natural menopause and development of T2DM and the influence of postmenopausal obesity status on this association.
The data for this study was derived from one center (Beijing) of the REACTION study. After screening through our inclusion and exclusion criteria, 2689 postmenopausal women who completed a 3-year follow-up were included. Logistic regression analysis was conducted to clarify the association of the age at natural menopause with the development of T2DM.
After adjustment for potential confounders, there was no significant association between the age at natural menopause and development of T2DM for all subjects. However, when subjects were stratified along the postmenopausal obesity status at baseline, in the presence or absence of obesity, we found a surprising contradictory association in two subgroups: late menopause (age >50 years) was associated with an increased risk (OR, 1.45; 95% CI, 1.02 to 2.05) of developing T2DM in the postmenopausal group without obesity, whereas we found a reduced risk (OR, 0.43; 95% CI, 0.27 to 0.71) in the postmenopausal group with obesity. Moreover, we found that early menopausal women (age ≤45 years) with postmenopausal obesity had the highest risk (OR, 2.10; 95% CI, 1.11 to 4.00) of developing T2DM compared with all other postmenopausal women.
Postmenopausal obesity status may influence the association of age at natural menopause and the development of T2DM.
自然绝经年龄与 2 型糖尿病(T2DM)之间的关系存在矛盾,尤其是在肥胖混杂的情况下。因此,我们旨在研究自然绝经年龄与 T2DM 发病的关系,以及绝经后肥胖状态对这种关系的影响。
本研究的数据来自 REACTION 研究的一个中心(北京)。经过我们的纳入和排除标准筛选,共纳入 2689 名完成 3 年随访的绝经后妇女。采用逻辑回归分析明确自然绝经年龄与 T2DM 发病的关系。
在调整了潜在混杂因素后,所有受试者的自然绝经年龄与 T2DM 的发病均无显著相关性。然而,当根据基线时绝经后肥胖状况对受试者进行分层时,在存在或不存在肥胖的情况下,我们在两个亚组中发现了一个令人惊讶的矛盾关联:晚绝经(年龄>50 岁)与绝经后无肥胖组发生 T2DM 的风险增加相关(OR,1.45;95%CI,1.02 至 2.05),而在绝经后肥胖组中风险降低(OR,0.43;95%CI,0.27 至 0.71)。此外,我们发现绝经后肥胖的早绝经(年龄≤45 岁)妇女发生 T2DM 的风险最高(OR,2.10;95%CI,1.11 至 4.00),与所有其他绝经后妇女相比。
绝经后肥胖状态可能影响自然绝经年龄与 T2DM 发病的关系。