title: Age at menopause in women with type 1 diabetes mellitus: the OVADIA study.
abstract: OBJECTIVE
  Is type 1 diabetes a determinant of advanced ovarian ageing, resulting in an early age at natural menopause?
  
  
  CONCLUSIONS
  No clear evidence was provided that type 1 diabetes is a determinant of accelerated ovarian ageing resulting in an early menopause.
  
  
  BACKGROUND
  The association between type 1 diabetes and early menopause has been examined previously with inconsistent results.
  
  
  METHODS
  A cross-sectional study was performed in 140 post-menopausal women with, and 5426 post-menopausal women without, diabetes.
  
  
  METHODS
  Both women with and without diabetes had experienced natural menopause. Study participants filled out a standardized questionnaire including report of their age at last menstrual period. Differences in menopausal age were analysed using linear regression analyses, with adjustment for possible confounders.
  
  
  RESULTS
  Mean age at natural menopause was 49.8 ± 4.7 years in women with type 1 diabetes and 49.8 ± 4.1 in women without diabetes. Linear regression analyses showed that type 1 diabetes was not associated with an earlier menopause compared with the reference group without diabetes, after adjustment for age, smoking history and parity (difference in age at menopause between women with type 1 diabetes and reference group 0.34 years, 95% confidence interval -0.34, 1.01).
  
  
  CONCLUSIONS
  Age at menopause was self-reported and assessed retrospectively. We had no information regarding microvascular complications therefore a possible association between vascular health and menopausal age could not be investigated.
  
  
  CONCLUSIONS
  It has been hypothesized that the possible mechanism behind an accelerated ovarian ageing process in type 1 diabetes is prolonged poor glycaemic control and subsequent effects on vascular health. The improved glycaemic control during the last decades may have prevented vascular damage from occurring to an extent that would affect organ function. Nevertheless, the present findings are reassuring for reproductive health prospects in women with type 1 diabetes.
authors.affiliation: Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands f.yarde@umcutrecht.nl.
authors.forename: F
authors.initials: F
authors.lastname: Yarde
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Y T
authors.initials: YT
authors.lastname: van der Schouw
authors.affiliation: Department of Internal Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: H W
authors.initials: HW
authors.lastname: de Valk
authors.affiliation: Birth Center, University Medical Center Utrecht, PO Box 85090, 3508 AB Utrecht, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Franx
authors.affiliation: Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: M J C
authors.initials: MJ
authors.lastname: Eijkemans
authors.affiliation: Department of Vascular Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Spiering
authors.affiliation: Department of Reproductive Medicine and Gynaecology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: F J M
authors.initials: FJ
authors.lastname: Broekmans
mesh_terms: D000375:Aging; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D005260:Female; D006801:Humans; D016014:Linear Models; D008594:Menopause, Premature; D008875:Middle Aged; D009426:Netherlands; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D057566:Self Report
keywords: age at menopause; natural menopause; ovarian ageing; type 1 diabetes; vascular health