Menopause in Type 1 Diabetic Women

Is it Premature?

Janice S. Dorman, Ann R. Steenkiste, Thomas P. Foley, Elsa S. Strotmeyer, James P. Burke, Lewis H. Kuller, Chian K Kwoh

Research output: Contribution to journalArticle

116 Citations (Scopus)

Abstract

Women with type 1 diabetes have a delayed menarche and a greater prevalence of menstrual disorders than women without diabetes. However, little is known about the menopause transition among type 1 diabetic women. The Familial Autoimmune and Diabetes (FAD) Study recruited both adult individuals who were identified from the Children's Hospital of Pittsburgh Type 1 Diabetes Registry for the years 1950-1964 and their family members. Unrelated nondiabetic control probands and their relatives were also evaluated. Women with type 1 diabetes (n = 143) compared with nondiabetic sisters (n = 186) or unrelated control subjects (n = 160) were more likely to have an older age at menarche (13.5, 12.5, and 12.6 years, respectively, P < 0.001), more menstrual irregularities before 30 years of age (45.7, 33.3, and 33.1%, respectively, P = 0.04), and a younger age at menopause (41.6, 49.9, and 48.0 years, respectively, P = 0.05). This resulted in a 6-year reduction in the number of reproductive years (30.0, 37.0, and 35.2 years, respectively, P = 0.05) for women with type 1 diabetes. Risk factors univariately associated with earlier menopause included type 1 diabetes (hazard ratio [HR] 1.99, P = 0.04), menstrual irregularities before 30 years of age (HR 1.87, P = 0.04), nulliparity (HR 2.14, P = 0.01), and unilateral oophorectomy (HR 6.51, P < 0.0001). Multivariate analysis confirmed that type 1 diabetes (HR 1.98, P = 0.056), menstrual irregularities by 30 years of age (HR 2.36, P = 0.01), and unilateral oophorectomy (HR 9.76, P < 0.0001) were independent determinants of earlier menopause in our cohort. We hypothesize that an earlier menopause, which resulted in a 17% decrease in reproductive years, is a major unstudied complication of type 1 diabetes.

Original languageEnglish (US)
Pages (from-to)1857-1862
Number of pages6
JournalDiabetes
Volume50
Issue number8
StatePublished - Aug 2001
Externally publishedYes

Fingerprint

Menopause
Type 1 Diabetes Mellitus
Menarche
Ovariectomy
Parity
Registries
Siblings
Multivariate Analysis

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Dorman, J. S., Steenkiste, A. R., Foley, T. P., Strotmeyer, E. S., Burke, J. P., Kuller, L. H., & Kwoh, C. K. (2001). Menopause in Type 1 Diabetic Women: Is it Premature? Diabetes, 50(8), 1857-1862.

Menopause in Type 1 Diabetic Women : Is it Premature? / Dorman, Janice S.; Steenkiste, Ann R.; Foley, Thomas P.; Strotmeyer, Elsa S.; Burke, James P.; Kuller, Lewis H.; Kwoh, Chian K.

In: Diabetes, Vol. 50, No. 8, 08.2001, p. 1857-1862.

Research output: Contribution to journalArticle

Dorman, JS, Steenkiste, AR, Foley, TP, Strotmeyer, ES, Burke, JP, Kuller, LH & Kwoh, CK 2001, 'Menopause in Type 1 Diabetic Women: Is it Premature?', Diabetes, vol. 50, no. 8, pp. 1857-1862.
Dorman JS, Steenkiste AR, Foley TP, Strotmeyer ES, Burke JP, Kuller LH et al. Menopause in Type 1 Diabetic Women: Is it Premature? Diabetes. 2001 Aug;50(8):1857-1862.
Dorman, Janice S. ; Steenkiste, Ann R. ; Foley, Thomas P. ; Strotmeyer, Elsa S. ; Burke, James P. ; Kuller, Lewis H. ; Kwoh, Chian K. / Menopause in Type 1 Diabetic Women : Is it Premature?. In: Diabetes. 2001 ; Vol. 50, No. 8. pp. 1857-1862.
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abstract = "Women with type 1 diabetes have a delayed menarche and a greater prevalence of menstrual disorders than women without diabetes. However, little is known about the menopause transition among type 1 diabetic women. The Familial Autoimmune and Diabetes (FAD) Study recruited both adult individuals who were identified from the Children's Hospital of Pittsburgh Type 1 Diabetes Registry for the years 1950-1964 and their family members. Unrelated nondiabetic control probands and their relatives were also evaluated. Women with type 1 diabetes (n = 143) compared with nondiabetic sisters (n = 186) or unrelated control subjects (n = 160) were more likely to have an older age at menarche (13.5, 12.5, and 12.6 years, respectively, P < 0.001), more menstrual irregularities before 30 years of age (45.7, 33.3, and 33.1{\%}, respectively, P = 0.04), and a younger age at menopause (41.6, 49.9, and 48.0 years, respectively, P = 0.05). This resulted in a 6-year reduction in the number of reproductive years (30.0, 37.0, and 35.2 years, respectively, P = 0.05) for women with type 1 diabetes. Risk factors univariately associated with earlier menopause included type 1 diabetes (hazard ratio [HR] 1.99, P = 0.04), menstrual irregularities before 30 years of age (HR 1.87, P = 0.04), nulliparity (HR 2.14, P = 0.01), and unilateral oophorectomy (HR 6.51, P < 0.0001). Multivariate analysis confirmed that type 1 diabetes (HR 1.98, P = 0.056), menstrual irregularities by 30 years of age (HR 2.36, P = 0.01), and unilateral oophorectomy (HR 9.76, P < 0.0001) were independent determinants of earlier menopause in our cohort. We hypothesize that an earlier menopause, which resulted in a 17{\%} decrease in reproductive years, is a major unstudied complication of type 1 diabetes.",
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