Menopause Unit, 2nd Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, Athens, Greece.
Endocrine Unit and Diabetes Centre, Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece.
Nat Rev Endocrinol. 2022 Oct;18(10):608-622. doi: 10.1038/s41574-022-00708-0. Epub 2022 Jul 7.
The menopausal transition is an impactful period in women's lives, when the risk of cardiovascular disease is accelerated. Similarly, diabetes mellitus profoundly impacts cardiovascular risk. However, the interplay between menopause and diabetes mellitus has not been adequately studied. The menopausal transition is accompanied by metabolic changes that predispose to diabetes mellitus, particularly type 2 diabetes mellitus (T2DM), as menopause results in increased risk of upper body adipose tissue accumulation and increased incidence of insulin resistance. Equally, diabetes mellitus can affect ovarian ageing, potentially causing women with type 1 diabetes mellitus and early-onset T2DM to experience menopause earlier than women without diabetes mellitus. Earlier age at menopause has been associated with a higher risk of T2DM later in life. Menopausal hormone therapy can reduce the risk of T2DM and improve glycaemic control in women with pre-existing diabetes mellitus; however, there is not enough evidence to support the administration of menopausal hormone therapy for diabetes mellitus prevention or control. This Review critically appraises studies published within the past few years on the interaction between diabetes mellitus and menopause and addresses all clinically relevant issues, such as the effect of menopause on the development of T2DM, and the management of both menopause and diabetes mellitus.
绝经期是女性生活中一个影响重大的时期，心血管疾病的风险在此期间加速增加。同样，糖尿病也深刻地影响心血管风险。然而，绝经和糖尿病之间的相互作用尚未得到充分研究。绝经过渡伴随着代谢变化，易患糖尿病，特别是 2 型糖尿病（T2DM），因为绝经会增加上半身脂肪组织积累的风险，并增加胰岛素抵抗的发生率。同样，糖尿病也会影响卵巢衰老，可能导致 1 型糖尿病和早发 T2DM 的女性比没有糖尿病的女性更早绝经。绝经年龄较早与以后发生 T2DM 的风险增加有关。绝经激素治疗可以降低患有预先存在的糖尿病的女性发生 T2DM 的风险，并改善血糖控制；然而，没有足够的证据支持绝经激素治疗用于预防或控制糖尿病。本综述批判性地评价了过去几年发表的关于糖尿病和绝经之间相互作用的研究，并解决了所有与临床相关的问题，例如绝经对 T2DM 发展的影响，以及绝经和糖尿病的管理。
