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Low premenopausal estradiol levels increase future diabetes risk

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December 16, 2016

Women transitioning through menopause may have a higher risk for diabetes if they had lower premenopausal estradiol levels and a slower rate of follicle-stimulating hormone change during the early transition, according to recent data.

Sung Kyun Park, MPH, ScD, assistant professor of epidemiology and assistant professor of environmental health sciences at the University of Michigan School of Public Health in Ann Arbor, and colleagues evaluated data from the Study of Women’s Health Across the Nation (SWAN) on 1,407 premenopausal women (mean age, 46.4 years) who experienced natural menopause from baseline to the 12th annual follow-up visit. Researchers sought to determine the relationship between changes in estradiol and FSH levels during menopausal transition and incident diabetes.

The mean age at which participants experienced the final menstrual period was 51.8 years. Overall, 132 participants developed diabetes in late perimenopause or after menopause (9.4%; incidence of 9 per 1,000 person-years) during a median 11 years of follow-up. Compared with participants who did not develop diabetes, participants who developed diabetes had lower baseline estradiol levels.

A lower risk for incident diabetes was associated with each interquartile range increase in the estradiol intercept (75.2 pmol/L; HR = 0.53; 95% CI, 0.27-1.06) in the fully adjusted model with age, BMI, smoking status, education and race/ethnicity. A greater rate of increase in FSH more than 2 years before the final menstrual period was significantly associated with a lower risk for incident diabetes (HR = 0.31; 95% CI, 0.1-0.94).

“In the present study, we found that lower premenopausal [estradiol] levels and a slower rate of FSH increase during the early transition were associated with a higher risk of developing diabetes as women transition through the menopause, independently of age and obesity,” the researchers wrote. “Given that obesity and excess fat play an important role in not only diabetes risk itself, but the changes in [estradiol] and FSH over the menopausal transition, these findings provide support for the relevance of an important strategy for preventive intervention: Weight control in earlier midlife is important to prevent future diabetes development. These results suggest the importance of monitoring for diabetes during the menopausal transition as well as the importance of adopting healthy diets and increasing exercise during this life stage.” – by Amber Cox

Disclosure: The researchers report no relevant financial disclosures.

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