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Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study

Although both obesity and menopause are associated with increased risk of diabetes mellitus (DM), the association between obesity and DM according to menopausal status remains uncertain. Therefore, we conducted a study to examine the relationship between obesity and incidence of diabetes mellitus (D...

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Autores principales: Lee, Han Rim, Shin, Jungeun, Han, Kyungdo, Chang, Jiwon, Jeong, Su-Min, Chon, Seung Joo, Choi, Soo Jung, Shin, Dong Wook
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584465/
https://www.ncbi.nlm.nih.gov/pubmed/34768709
http://dx.doi.org/10.3390/jcm10215189
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author Lee, Han Rim
Shin, Jungeun
Han, Kyungdo
Chang, Jiwon
Jeong, Su-Min
Chon, Seung Joo
Choi, Soo Jung
Shin, Dong Wook
author_facet Lee, Han Rim
Shin, Jungeun
Han, Kyungdo
Chang, Jiwon
Jeong, Su-Min
Chon, Seung Joo
Choi, Soo Jung
Shin, Dong Wook
author_sort Lee, Han Rim
collection PubMed
description Although both obesity and menopause are associated with increased risk of diabetes mellitus (DM), the association between obesity and DM according to menopausal status remains uncertain. Therefore, we conducted a study to examine the relationship between obesity and incidence of diabetes mellitus (DM) in premenopausal and postmenopausal women. Total of 926,196 premenopausal and 1,193,881 postmenopausal women who underwent health examinations from 2009 to 2014 were identified using the database of the Korean National Health Insurance Service. We compared the incidence and risk of DM according to body mass index (BMI) and waist circumference (WC) in the two groups of women. Cox proportional hazards analyses were performed to evaluate the association between the presence of obesity and risk of DM according to menopausal state. During the 7.8-year follow-up period, 37,736 (4.1%) premenopausal women and 121,102 (10.1%) postmenopausal women were diagnosed with DM. Compared to the reference group (BMI 18.5–23), a stronger association between obesity and risk of DM was observed in both pre- and postmenopausal women: multivariable-adjusted hazard ratios and 95% confidence intervals for BMI subgroups <18.5, 23–25, 25–30, and >30 were 0.62 (0.54, 0.70), 1.91 (1.85, 1.97), 3.38 (3.28, 3.47), and 6.25 (6.02, 6.48), respectively (p trend < 0.001) in premenopausal women and 0.87 (0.82, 0.92), 1.44 (1.41, 1.46), 2.00 (1.97, 2.03), and 2.96 (2.89, 3.02) in postmenopausal women (p trend < 0.001, p-interaction < 0.001). A similar trend was observed for WC. Subgroup analyses of women aged 45 to 55 also showed a stronger association with DM in premenopausal than in postmenopausal women. In conclusion, the association between obesity and DM was stronger in premenopausal women than in postmenopausal women. As estrogens are synthesized in adipose tissue by aromatization of androgens after menopause, increased estrogen levels in obese postmenopausal might have a protective effect against DM.
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spelling pubmed-85844652021-11-12 Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study Lee, Han Rim Shin, Jungeun Han, Kyungdo Chang, Jiwon Jeong, Su-Min Chon, Seung Joo Choi, Soo Jung Shin, Dong Wook J Clin Med Article Although both obesity and menopause are associated with increased risk of diabetes mellitus (DM), the association between obesity and DM according to menopausal status remains uncertain. Therefore, we conducted a study to examine the relationship between obesity and incidence of diabetes mellitus (DM) in premenopausal and postmenopausal women. Total of 926,196 premenopausal and 1,193,881 postmenopausal women who underwent health examinations from 2009 to 2014 were identified using the database of the Korean National Health Insurance Service. We compared the incidence and risk of DM according to body mass index (BMI) and waist circumference (WC) in the two groups of women. Cox proportional hazards analyses were performed to evaluate the association between the presence of obesity and risk of DM according to menopausal state. During the 7.8-year follow-up period, 37,736 (4.1%) premenopausal women and 121,102 (10.1%) postmenopausal women were diagnosed with DM. Compared to the reference group (BMI 18.5–23), a stronger association between obesity and risk of DM was observed in both pre- and postmenopausal women: multivariable-adjusted hazard ratios and 95% confidence intervals for BMI subgroups <18.5, 23–25, 25–30, and >30 were 0.62 (0.54, 0.70), 1.91 (1.85, 1.97), 3.38 (3.28, 3.47), and 6.25 (6.02, 6.48), respectively (p trend < 0.001) in premenopausal women and 0.87 (0.82, 0.92), 1.44 (1.41, 1.46), 2.00 (1.97, 2.03), and 2.96 (2.89, 3.02) in postmenopausal women (p trend < 0.001, p-interaction < 0.001). A similar trend was observed for WC. Subgroup analyses of women aged 45 to 55 also showed a stronger association with DM in premenopausal than in postmenopausal women. In conclusion, the association between obesity and DM was stronger in premenopausal women than in postmenopausal women. As estrogens are synthesized in adipose tissue by aromatization of androgens after menopause, increased estrogen levels in obese postmenopausal might have a protective effect against DM. MDPI 2021-11-06 /pmc/articles/PMC8584465/ /pubmed/34768709 http://dx.doi.org/10.3390/jcm10215189 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Han Rim
Shin, Jungeun
Han, Kyungdo
Chang, Jiwon
Jeong, Su-Min
Chon, Seung Joo
Choi, Soo Jung
Shin, Dong Wook
Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
title Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
title_full Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
title_fullStr Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
title_full_unstemmed Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
title_short Obesity and Risk of Diabetes Mellitus by Menopausal Status: A Nationwide Cohort Study
title_sort obesity and risk of diabetes mellitus by menopausal status: a nationwide cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8584465/
https://www.ncbi.nlm.nih.gov/pubmed/34768709
http://dx.doi.org/10.3390/jcm10215189
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