title: Menopause and risk of diabetes in the Diabetes Prevention Program.
abstract: OBJECTIVE
  The study objectives were to examine the association between menopause status and diabetes risk among women with glucose intolerance and to determine if menopause status modifies response to diabetes prevention interventions.
  
  
  METHODS
  The study population included women in premenopause (n = 708), women in natural postmenopause (n = 328), and women with bilateral oophorectomy (n = 201) in the Diabetes Prevention Program, a randomized placebo-controlled trial of lifestyle intervention and metformin among glucose-intolerant adults. Associations between menopause and diabetes risk were evaluated using Cox proportional hazard models that adjusted for demographic variables (age, race/ethnicity, family history of diabetes, history of gestational diabetes mellitus), waist circumference, insulin resistance, and corrected insulin response. Similar models were constructed after stratification by menopause type and hormone therapy use.
  
  
  RESULTS
  After adjustment for age, there was no association between natural menopause or bilateral oophorectomy and diabetes risk. Differences by study arm were observed in women who reported bilateral oophorectomy. In the lifestyle arm, women with bilateral oophorectomy had a lower adjusted hazard for diabetes (hazard ratio [HR], 0.19; 95% CI, 0.04-0.94), although observations were too few to determine if this was independent of hormone therapy use. No significant differences were seen in the metformin (HR, 1.29; 95% CI, 0.63-2.64) or placebo arms (HR, 1.37; 95% CI, 0.74-2.55).
  
  
  CONCLUSIONS
  Among women at high risk for diabetes, natural menopause was not associated with diabetes risk and did not affect response to diabetes prevention interventions. In the lifestyle intervention, bilateral oophorectomy was associated with a decreased diabetes risk.
authors.affiliation: Department of Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kim
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Edelstein
authors.forename: Jill P
authors.initials: JP
authors.lastname: Crandall
authors.forename: Dana
authors.initials: D
authors.lastname: Dabelea
authors.forename: Abbas E
authors.initials: AE
authors.lastname: Kitabchi
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hamman
authors.forename: Maria G
authors.initials: MG
authors.lastname: Montez
authors.forename: Leigh
authors.initials: L
authors.lastname: Perreault
authors.forename: Mary A
authors.initials: MA
authors.lastname: Foulkes
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000517:prevention & control*; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage*; D008019:Life Style; D008593:Menopause; D008687:Metformin / Q000008:administration & dosage*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D011236:Prediabetic State / Q000188:drug therapy / Q000517:prevention & control; D016016:Proportional Hazards Models; D011788:Quality of Life; D018570:Risk Assessment; D016387:Women's Health
chemical_list: D007004:Hypoglycemic Agents; D008687:Metformin