WOMEN WITH EARLY or normal onset menopause are at a higher risk of developing type 2 diabetes than those with late onset menopause, according to new research.
Previous research has shown that women with early onset menopause (younger than 45 years old) have an increased risk of cardiovascular disease (CVD). In contrast, an onset of menopause at 50-54 years old is linked to reduced risk of CVD and mortality.
The researchers, from the University Medical Centre in the Netherlands, examined a total of 6819 women over the age of 45 to analyse the association between age of menopause and the risk of diabetes.
A total of 3969 women were included in the final study. Some women were excluded because, for example, they hadn’t reached menopause, already had diabetes, or had a non-natural menopause.
Women’s menopausal status was monitored using a home interview questionnaire.
During baseline visits and follow-up visits, the prevalence of diabetes was determined using the participant’s general practitioners’ records, hospital discharge letters, and glucose measurements from visits.
All potential cases of diabetes were examined by two study physicians.
To consider the impact of potential confounding variables, background health information was collected, including current health status, medical history, medication use, smoking behaviour, socioeconomic status, educational status, alcohol consumption and the number of pregnancies had.
The research, published in Diabetologia, found that of the 3639 women without diabetes during the baseline visit, a total of 348 developed type 2 diabetes over a follow-up average of 9 years.
Compared with women having late menopause (55 years old or older), those with the earliest menopause (younger than 40 years old) were almost four times more likely to have developed diabetes.
Those who went through menopause at 40-44 years old were two times more likely to develop diabetes, while those who went through it at 45-55 years old were 60% more likely to develop diabetes than those with late menopause.
Overall, the risk of developing type 2 diabetes reduced by 4% per year older the woman was when she experience menopause.
However, the researchers have shown in previous work that higher endogenous estradiol levels in postmenopausal women have been linked to an increased risk of type 2 diabetes.
This factor isn’t supported by this new study, which shows that levels of endogenous sex hormones, both of which are associated with menopause and type 2 diabetes, could not explain the association between early onset menopause and risk of diabetes.
Because of this, the researchers suggested that further studies are needed.
The researchers also noted that women with less efficient DNA repair and maintenance genes might age faster compared to women with the more efficient repair and maintenance genes.
As a result of this, they said early menopause might be a good predictor of upcoming health problems related to this less efficient DNA repair.
“Our findings might suggest that the risk of diabetes related to menopause is already there before menopause begins,” the authors of the study said.
“This could explain why other risk factors for diabetes do not explain the link between menopause and type 2 diabetes – early menopause is an independent marker for type two diabetes, indicated that something else is the driving force behind this observation, possibly defective DNA repair and maintenance.”