Dr Sopio Tatulashvili Avicenne Hospital Bobigny, France

How Do Puberty, Menopause and BCPs Affect Risk of Diabetes?

MedicalResearch.com Interview with:
Dr Sopio Tatulashvili Avicenne Hospital Bobigny, FranceDr Sopio Tatulashvili
Avicenne Hospital
Bobigny, France

MedicalResearch.com: What is the background for this study?

Response: Diabetes and pre-diabetes are associated with increased cardiovascular morbidity and mortality. Early screening and the treatment of glucose metabolism disorders could lower the risk of further complications. Furthermore, type 2 diabetes can be prevented. For this purpose, it is of major importance to better identify the risk factors of type 2 diabetes. Hormonal factors are increasingly suspected to play a role in the etiology of type 2 diabetes. The aim of this study was to determine the associations between various hormonal factors and the risk of incident type 2 diabetes in the large prospective female E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de L’Education Nationale) cohort study. Based on a very detailed set of information available in 83,799 women from the large prospective E3N cohort study followed for 22 years, we have been able to clarify the relationships between various hormonal factors and type 2 diabetes risk.  

MedicalResearch.com: What are the main findings?

Response: In multivariable models, the following factors were inversely associated with incident type 2 diabetes: older age at menarche (≥ 14 years versus < 12 years: HR = 0.88 [0.81-0.95]), elevated number of menstrual cycles (≥ 471.7 cycles versus < 391.3 cycles: HR = 0.75 [0.68-0.82]), older age at menopause (≥ 52 years versus < 47 years: HR = 0.70 [0.63-0.78]), longer duration of exposure to sex hormones (≥ 38.0 years versus < 31.9 years: HR = 0.66 [0.61-0.73]) and breastfeeding (HR = 0.90 [0.85-0.95]).

The following variables were positively associated with type 2 diabetes risk: longer duration of menstrual cycles (≥ 32 days versus ≤ 24 days: HR = 1.23 [95% CI: 1.07-1.41]) and use of contraceptive pill (HR = 1.33 [1.25-1.42]). We also observed an inverse and linear relationship between age at menopause and risk of type 2 diabetes.  

MedicalResearch.com: What should readers take away from your report?

Response: We have shown that a longer exposure to endogenous sex hormones that occurs late in life as well as breastfeeding were associated with a lower risk of developing type 2 diabetes, independently of classical risk factors.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Various hypotheses are proposed to explain physio-pathologic pathways of our findings. Therefore, further studies are needed to explain the causal effect.  

Citation:

EASD 2019

Later puberty and later menopause associated with lower risk of type 2 diabetes in women, while use of contraceptive pill and longer time between periods associated with higher risk

 

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Last Updated on September 18, 2019 by Marie Benz MD FAAD