Open Access女性绝经前性腺激素因素和2型糖尿病的发病率:E3N队列研究中83799名女性的22年随访
Author(s) -
Tatulashvili Sopio,
Gusto Gaelle,
Cosson Emmanuel,
Balkau Beverley,
Gourdy Pierre,
Bonnet Fabrice,
Bihan Hélène,
Fagherazzi Guy
Publication year - 2021
Publication title -
journal of diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.949
H-Index - 43
eISSN - 1753-0407
pISSN - 1753-0393
DOI - 10.1111/1753-0407.13129
Subject(s) - medicine , menarche , menopause , hazard ratio , type 2 diabetes , diabetes mellitus , hormonal contraception , cohort study , cohort , proportional hazards model , hormone , breastfeeding , endocrinology , physiology , obstetrics , population , confidence interval , pediatrics , family planning , environmental health , research methodology
Background In many populations the incidence of type 2 diabetes is higher in men than in women. This may be explained by exposure to female gonadal hormones, but so far, there is no consensus on their role over the life course in type 2 diabetes etiology. Methods Data are from 83 799 French women from the E3N (Etude Épidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale) cohort study, followed for 22 years. Multivariable Cox models including classical risk factors were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between gonadal hormonal factors and incident type 2 diabetes. Results Older age at menarche, more menstrual cycles, older age at menopause, longer duration of exposure to gonadal hormones and breastfeeding were inversely associated with incident type 2 diabetes cases (n = 4806). While a longer duration of menstrual cycles (HR = 1.23 [95% CI: 1.07‐1.41] comparing ≥32 vs ≤24 days) and use of contraceptive pills (HR = 1.33 [1.25‐1.42]) were associated with a greater risk of type 2 diabetes. Conclusions In women, a longer exposure to endogenous gonadal hormones with a later menopause as well as breastfeeding were associated with a lower risk of developing type 2 diabetes, independently of classical diabetes risk factors. In contrast, the use of contraceptive agents was associated with incident diabetes, but the influence of each type of contraception and of exposure duration remain to be investigated.