MedicalResearch.com Interview with:
Department of Epidemiology
Erasmus University Medical Center
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: It is known that women with early onset of menopause (age below 45 years) have an increased risk of cardiovascular disease and overall mortality. This increased risk is thought to be due to the adverse effects of menopause on cardiovascular risk factors.
Type 2 diabetes is a major risk factor for cardiovascular disease, but it remains unclear whether age at menopause affects the risk of developing type 2 diabetes. Our study shows that women who experience menopause before the age of 40 were almost 4 times more likely to develop type 2 diabetes than those experiencing menopause after 55 years old. Moreover, those who had menopause between 40 to 44 years were 2.4 times more likely to have diabetes later in life. The risk of having diabetes reduced by 4 % per year older the women experienced menopause. Adjustment for the various confounding factors and differences in genetic predisposition to early menopause did not affect the results.
MedicalResearch.com: What should clinicians and patients take away from your report?
Response: Our findings show that, women with early or normal onset menopause are at a higher risk of developing type 2 diabetes than those with late onset of menopause. This association was not affected by potential intermediate factors suggesting that, early onset of menopause might be an independent marker for type 2 diabetes in postmenopausal women. Hence, menopause might be a critical period to evaluate women’s risk for type 2 diabetes as it may be an appropriate time to introduce interventions to reduce this risk. So women who enter menopause early may want to regularly control their blood sugar, cholesterol, lipid levels and other factors affecting their health.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Menopause can be a sign of advanced ageing. Women equipped with less efficient DNA repair and maintenance genes might age faster compared to women with the more efficient repair and maintenance genes. Hence early menopause might be a good predictor of upcoming health problems related to this less efficient DNA repair. However, in our studies genetic factors predisposing to early menopause did not explain our findings. Nevertheless, genetic studies have identified approximately 56 single-nucleotide polymorphism (SNP) across human genome that explain only a minor fraction of the inter-individual variation in the age at menopause. Epigenetic modifications – such as DNA methylation and histone modifications might constitute an additional pathway leading to menopause onset and type 2 diabetes. Therefore, future studies should explore epigenetic marks related to menopause onset and whether the identified epigenetic signatures can explain the association we showed in our study. Furthermore, we need to investigate whether the timing of natural menopause has any added value in type 2 diabetes prediction and prevention.
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Taulant Muka, Eralda Asllanaj, Naim Avazverdi, Loes Jaspers, Najada Stringa, Jelena Milic, Symen Ligthart, M. Arfan Ikram, Joop S. E. Laven, Maryam Kavousi, Abbas Dehghan, Oscar H. Franco. Age at natural menopause and risk of type 2 diabetes: a prospective cohort study. Diabetologia, 2017; DOI: 10.1007/s00125-017-4346-8
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