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Early menopause may shorten life expectancy, increase diabetes risk

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October 19, 2018

Early onset of menopause is associated with a shorter life span and longer duration of type 2 diabetes, according to findings published in Menopause.

“In women, [type 2 diabetes] often manifests during midlife and thus coincides with the timing of the menopausal transition,” Eralda Asllanaj, MD, MSc, DSc, of the department of epidemiology at Erasmus University Medical Center in the Netherlands, and colleagues wrote. “Emerging evidence shows an association between age at menopause and diabetes, with studies reporting almost a twofold increased risk of [type 2 diabetes] with early onset of menopause. Also, it is well-established that early onset of menopause is associated with early death. This could be important because, although mortality rates for women with non-[type 2 diabetes] have declined over time, mortality rates for women with [type 2 diabetes] may have actually increased.”

Using information from the Rotterdam Study, a population-based examination of adults aged at least 45 years, the researchers analyzed data from 3,650 postmenopausal women from Rotterdam, the Netherlands. Of those, 3,240 did not have diabetes before the trial began. Because the Rotterdam Study had several cohorts, the researchers looked at data from three separate time periods from 1997 to 2008.

The researchers also segmented the study population into three groups based on the age of initial menopause occurrence. These groups were early (mean age at menopause, 41 years), normal (mean age at menopause, 50 years) and late (mean age at menopause, 56 years).

Among 3,240 women without type 2 diabetes at baseline, 305 were diagnosed with the disease during the study and 489 women died.

Mortality risk among women without diabetes who reported early menopause was higher (HR = 1.42; 95% CI, 1.01-2) than for those with late menopause (HR = 1) and normal menopause (HR = 1.13; 95% CI, 0.85-1.49). Mortality was also higher for women with diabetes who had earlier occurrence of menopause (HR = 1.64; 95% CI, 0.93-2.88) than those who had normal (HR = 0.85; 95% CI, 0.52-1.39) and late (HR = 1) menopause.

Compared with late and normal menopause occurrence, those with early menopause had difference in life expectancy of –3.5 (95% CI, –6.6 to –0.8) and –3.1 (95% CI, –5.1 to –1.1) years, respectively. Women with normal menopause had a –0.5-year difference in life expectancy (95% CI, –2.1 to 1.3) compared with those with late menopause.

Women with early menopause and no diabetes had a life expectancy difference of –4.6 years (95% CI, –8.9 to –0.9) vs. those with late menopause and a difference of –3.3 years (95% CI, –6 to –0.6) compared with the normal menopause group. Conversely, women with early menopause and type 2 diabetes had life expectancy differences of 1.1 (95% CI, –1.8 to 4.4) and 0.2 (95% CI, –2 to 2.8) years compared with the late and normal menopause groups, respectively.

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“The decreased life expectancy without diabetes among women with early menopause might be due to the increased risk of [type 2 diabetes] and mortality associated with early menopause,” the researchers wrote. “The higher risk of diabetes in women with early age at natural menopause might reflect an earlier diagnosis of diabetes across the life span, and therefore a decreased life expectancy without [type 2 diabetes], although the difference in years lived overall and without [type 2 diabetes] did not differ significantly. Furthermore, early menopause was also associated with an increased mortality risk among participants without [type 2 diabetes], resulting in a further decrease in total life expectancy and number of years lived without [type 2 diabetes].” – by Phil Neuffer

Disclosures: The authors report no relevant financial disclosures.

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