Risk factors for type 2 diabetes in women attending menopause clinics in Italy: a cross-sectional study.
OBJECTIVE
To analyze risk factors for type 2 diabetes among women attending menopause clinics in Italy for counselling about the menopause.


METHODS
Women attending a network of first-level outpatient menopause clinics in Italy for general counselling about menopause or treatment of menopausal symptoms.


METHODS
Cross-sectional study with no exclusion criteria. Type 2 diabetes was defined according to National Diabetes Data Groups Indications and the fasting blood glucose at an oral glucose tolerance test within the previous year.


RESULTS
Out of the 44 694 considered in this analysis, 808 had a diagnosis of diabetes type 2 (1.8%). In comparison with women aged < 50 years, the multivariate odds ratios (OR) of type 2 diabetes were 1.31 (95% confidence interval (CI), 0.99-1.74) for women aged 50-52 years, 1.66 (95% CI, 1.27-2.17) at 53-56 years and 2.84 (95% CI, 2.20-3.67) in women aged > or = 57 years. Type 2 diabetes was less frequently reported in more educated women (OR high school/university vs. primary school = 0.44 (95% CI, 0.36-0.55)). Being overweight was associated with an increased risk of type 2 diabetes. In comparison with women reporting a low level of physical activity, the multivariate OR of type 2 diabetes was 0.67 (95% CI, 0.54-0.84) for women reporting regular physical activity. In comparison with premenopausal women, the multivariate OR of type 2 diabetes was 1.38 (95% CI, 1.03-1.84) in women with natural menopause. This finding was present also after allowing for the potential confounding effect of age. The multivariate OR of diabetes for users of hormonal replacement therapy was 0.58 (95% CI, 0.46-0.73).


CONCLUSIONS
This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.
Di Donato
P
P
Giulini
N A
NA
Bacchi Modena
A
A
Cicchetti
G
G
Comitini
G
G
Gentile
G
G
Cristiani
P
P
Careccia
A
A
Esposito
E
E
Gualdi
F
F
Golinelli
S
S
Bergamini
E
E
Masellis
G
G
Rastelli
S
S
Gigli
C
C
Elia
A
A
Marchesoni
D
D
Sticotti
F
F
Del Frate
G
G
Zompicchiatti
C
C
Marino
L
L
Costa
M R
MR
Pinto
P
P
Dodero
D
D
Storace
A
A
Spinelli
G
G
Quaranta
S
S
Bossi
C M
CM
Ollago
A
A
Omodei
U
U
Vaccari
M
M
Luerti
M
M
Repetti
F
F
Zandonini
G
G
Raspagliesi
F
F
Dolci
F
F
Gambarino
G
G
De Pasquale
B
B
Polizzotti
G
G
Borsellino
G
G
Alpinelli
P
P
Natale
N
N
Colombo
D
D
Belloni
C
C
Viani
A
A
Cecchini
G
G
Vinci
G W
GW
Samaja
B A
BA
Pasinetti
E
E
Penotti
M
M
Ognissanti
F
F
Pesando
P
P
Malanetto
C
C
Gallo
M
M
Dolfin
G
G
Tartaglino
P
P
Mossotto
D
D
Pistoni
A
A
Tarani
A
A
Rattazzi
P D
PD
Rossaro
D
D
Campanella
M
M
Arisi
E
E
Gamper
M
M
Salvatores
D
D
Bocchin
E
E
Stellin
G
G
Meli
G
G
Azzini
V
V
Tirozzi
F
F
Buoso
G
G
Fraioli
R
R
Marsoni
V
V
Cetera
C
C
Sposetti
R
R
Candiotto
E
E
Pignalosa
R
R
Del Pup
L
L
Bellati
U
U
Angeloni
C
C
Buonerba
M
M
Garzarelli
S
S
Santilli
C
C
Mucci
M
M
Di Nisio
Q
Q
Cappa
F
F
Pierangeli
I
I
Cordone
A
A
Falasca
L
L
Ferrante
D
D
Serra
G B
GB
Cirese
E
E
Todaro
P A
PA
Romanini
C
C
Spagnuolo
L
L
Lanzone
A
A
Donadio
C
C
Fabiani
M
M
Baldaccini
E
E
Votano
S
S
Bellardini
P
P
Favale
W
W
Monti
V
V
Bonomo
A
A
Boninfante
C E
CE
Pietrobattista
P
P
Massacesi
L
L
Donini
G
G
Del Savio
F
F
Palombi
L
L
Procaccioli
P
P
Romani
A
A
Romagnoli
G
G
Genazzani
A R
AR
Gambacciani
M
M
Scarselli
G
G
Curiel
P
P
De Leo
V
V
Melani
A
A
Levi D'Ancona
V
V
Giarrè
G
G
Di Gioia
E
E
Ceccarelli
P
P
Massi
G B
GB
Cosci
S
S
Gacci
G
G
Cascianini
A
A
Donati Sarti
C
C
Bircolotti
S
S
Pupita
P
P
Mincigrucci
M
M
Spadafora
A
A
Santeufemia
G
G
Marongiu
G
G
Lai
G R
GR
Lai
R
R
Dessole
S
S
D'Andrea
S A
SA
Coppola
Chiantera
A
A
De Placido
Arienzo
R
R
Pastore
A R
AR
Tamburrino
A
A
Cardone
A
A
Colacurci
N
N
Izzo
S
S
Tesauro
R
R
Pascarella
A
A
De Silvio
M G
MG
Di Prisco
L
L
Lauda
N
N
Sirimarco
F
F
Agrimi
C
C
Casarella
G
G
Senatore
G
G
Ronzini
S
S
Ruccia
G
G
De Carlo
G
G
Pisaturo
G
G
Carlomagno
F
F
Fasolino
A
A
Fiorillo
F
F
Sorrentino
R
R
Ercolano
V B
VB
Panariello
S
S
Brun
A
A
Tropea
P
P
Stigliano
C M
CM
Amoroso
A
A
Vadalà
P
P
Coco
A
A
Galati
G
G
Barese
G
G
Masciari
G
G
Pirillo
P
P
Gioffrè
T
T
Mastrantonio
P
P
Cardamone
A
A
D'Angelo
N
N
Valentino
G
G
Barretta
R
R
Ferraro
G
G
Ferruccio
C
C
Agostinelli
D
D
Corrado
G
G
Scopelliti
A
A
Schonauer
S
S
Trojano
V
V
Bongiovanni
F
F
Tinelli
F
F
Poddi
E R
ER
Scarpello
F
F
Colonna
L
L
Fischetti
G
G
Doria
R
R
Trombetta
G
G
Cocca
E B
EB
D'Amore
A
A
Di Masi
M
M
Liguori
R
R
Dimaggio
A
A
Laneve
M R
MR
Maolo
M C
MC
Gravina
G
G
Nacci
G
G
Nocera
F
F
Lupo
A
A
Giannola
C
C
Graziano
R
R
Mezzatesta
M
M
Vegna
G
G
Giannone
G
G
Palumbo
G
G
Cancellieri
F
F
Mondo
A
A
Cordopatri
A
A
Carrubba
M
M
Mazzola
V
V
Cincotta
L
L
D'Asta
S
S
Bono
A
A
Li Calsi
L
L
Cavallaro Nigro
S
S
Schilirò
S
S
Repici
A
A
Gullo
D
D
Orlando
A
A
Specchiale
F
F
Papotto
A
A
Abruzzo
Basilicata
Calabria
Campania
Emilia
Romagna
Giulia
Friuli Venezia
FV
Lazio
Liguria
Lombardia
Marche
Molise
Piemonte
Puglia
Sardegna
Sicilia
Toscana
Adige
Trentino Alto
TA
Umbria
D'Aosta
Valle
V
Veneto
Massacesi
A
A
Chiantera
A
A
Donati Sarti
C
C
De Aloysio
P
P
Omodei
U
U
Ognissanti
F
F
Campagnoli
C
C
Penotti
M
M
Gambacciani
A
A
Graziottin
A
A
Baldi
C
C
Colacurci
N
N
Corrado Tonti
G
G
Parazzini
F
F
Chatenoud
L
L
D017677:Age Distribution; D000554:Ambulatory Care Facilities; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004522:Educational Status; D005260:Female; D020249:Hormone Replacement Therapy; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008593:Menopause; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D012307:Risk Factors