Choi Mi Jin, Yu Juyoun
College of Nursing, Gyeongsang National University, Jinju-si 52727, Republic of Korea.
Department of Nursing, Changwon National University, Changwon-si 51140, Republic of Korea.
Healthcare (Basel). 2025 May 5;13(9):1062. doi: 10.3390/healthcare13091062.
The relationship between menopause and diabetes risk is unclear, with some studies indicating a weak association. This study examined changes in diabetes risk, β-cell function, and insulin sensitivity in relation to menopause.
In this community-based cohort study, data from 6684 visits to 1224 women over a 16-year follow-up were analyzed. Diabetes risk changes were assessed in relation to the different menopausal phases: premenopausal (≥3 years before menopause), perimenopausal (2 years before to 1 year after menopause), and postmenopausal (≥2 years after menopause). Changes in β-cell function and insulin sensitivity indices were tracked, and their relationship with diabetes risk was assessed. Generalized estimating equations and linear mixed models were used, adjusting for covariates including age at menopause and obesity.
Diabetes incidence was 18.6% among participants. The odds ratio (OR) of diabetes increased by 1.03 times annually during the premenopausal period (OR 1.03; 95% CI 1.02-1.04) and decreased during the postmenopausal period (OR 0.96; 95% CI 0.95-0.97). The incident diabetes groups showed a decline in insulin sensitivity and β-cell function, resulting in a decrease in the disposition indices over time. A large change in insulin sensitivity, especially during the period immediately before the onset of diabetes, increased the risk of diabetes (OR 1.88; 95% CI 1.33-2.67).
This study indicates an increased diabetes risk during the premenopausal periods, compared with that in the postmenopausal period, independent of age at menopause and obesity. Additionally, a decrease in insulin sensitivity followed by a subsequent decrease in β-cell function depending on the time of onset was related to the risk of diabetes. These findings enhance the understanding of diabetes risk and associated changes in insulin indices in relation to menopause, emphasizing the importance of health management and diabetes prevention for women in menopausal transition.
绝经与糖尿病风险之间的关系尚不清楚，一些研究表明存在微弱关联。本研究探讨了与绝经相关的糖尿病风险、β细胞功能和胰岛素敏感性的变化。
在这项基于社区的队列研究中，分析了1224名女性在16年随访期间6684次就诊的数据。根据不同的绝经阶段评估糖尿病风险变化：绝经前（绝经前≥3年）、围绝经期（绝经前2年至绝经后1年）和绝经后（绝经后≥2年）。追踪β细胞功能和胰岛素敏感性指数的变化，并评估它们与糖尿病风险的关系。使用广义估计方程和线性混合模型，并对包括绝经年龄和肥胖在内的协变量进行了调整。
参与者中糖尿病发病率为18.6%。绝经前期糖尿病的比值比（OR）每年增加1.03倍（OR 1.03；95%可信区间1.02 - 1.04），绝经后期则下降（OR 0.96；95%可信区间0.95 - 0.97）。新发糖尿病组的胰岛素敏感性和β细胞功能下降，导致随着时间推移处置指数降低。胰岛素敏感性的大幅变化，尤其是在糖尿病发病前的时期，会增加糖尿病风险（OR 1.88；95%可信区间1.33 - 2.67）。
本研究表明，与绝经后期相比，绝经前期糖尿病风险增加，且独立于绝经年龄和肥胖。此外，胰岛素敏感性降低随后根据发病时间β细胞功能随之下降与糖尿病风险相关。这些发现加深了对绝经相关糖尿病风险及胰岛素指标相关变化的理解，强调了绝经过渡阶段女性健康管理和糖尿病预防的重要性。
