Journal
DIABETES CARE
Volume 36, Issue 4, Pages 1012-1019Publisher
AMER DIABETES ASSOC
DOI: 10.2337/dc12-1020
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Funding
- European Union [LSHM_CT_2006_037197]
- NL Agency [IGE05012]
- Board of the University Medical Center Utrecht
- Medical Research Council
- Cancer Research UK
- Spanish Ministry of Health
- Navarre Regional Government
- CIBER Epidemiologia y Salud Publica
- Spanish Ministry of Health and Murcia Regional Government
- Spanish Ministry of Health [ISCII RETICC RD06/0020]
- Swedish Research Council
- Swedish Diabetes Association
- Swedish Heart-Lung Foundation
- German Cancer Aid and German Ministry of Research
- Danish Cancer Society
- Compagnia di San Paolo
- Asturias Regional Government
- Vasterboten County Council
- German Cancer Aid
- AIRE-ONLUS Ragusa
- AVIS-Ragusa
- Sicilian Regional Government
- Dutch Ministry of Public Health, Welfare and Sports
- Netherlands Cancer Registry
- LK Research Funds
- Dutch Prevention Funds
- Dutch ZON (Zorg Onderzoek Nederland)
- World Cancer Research Fund
- Statistics Netherlands
- Imperial College Biomedical Research Centre
- Novo Nordisk
- Medical Research Council [G1000143, G0401527, MC_UP_A100_1003, MC_U106179472, MC_UU_12015/2, MC_UU_12015/1] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0512-10114] Funding Source: researchfish
- MRC [MC_U106179472, MC_UU_12015/1, MC_UU_12015/2, MC_UP_A100_1003] Funding Source: UKRI
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OBJECTIVE-Age at menopause is an important determinant of future health outcomes, but little is known about its relationship with type 2 diabetes. We examined the associations of menopausal age and reproductive life span (menopausal age minus menarcheal age) with diabetes risk. RESEARCH DESIGN AND METHODS-Data were obtained from the InterAct study, a prospective case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition. A total of 3,691 postmenopausal type 2 diabetic case subjects and 4,408 subcohort members were included in the analysis, with a median follow-up of 11 years. Prentice weighted Cox proportional hazards models were adjusted for age, known risk factors for diabetes, and reproductive factors, and effect modification by BMI, waist circumference, and smoking was studied. RESULTS-Mean (SD) age of the subcohort was 59.2 (5.8) years. After multivariable adjustment, hazard ratios (HRs) of type 2 diabetes were 1.32 (95% CI 1.04-1.69), 1.09 (0.90-1.31), 0.97 (0.86-1.10), and 0.85 (0.70-1.03) for women with menopause at ages <40, 40-44, 45-49, and >= 55 years, respectively, relative to those with menopause at age 50-54 years. The HR per SD younger age at menopause was 1.08 (1.02-1.14). Similarly, a shorter reproductive life span was associated with a higher diabetes risk (HR per SD lower reproductive life span 1.06 [ 1.01-1.12]). No effect modification by BMI, waist circumference, or smoking was observed (P interaction all > 0.05). CONCLUSIONS-Early menopause is associated with a greater risk of type 2 diabetes. Diabetes Care 36:1012-1019, 2013
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