title: Association between changes in oestradiol and follicle-stimulating hormone levels during the menopausal transition and risk of diabetes.
abstract: To investigate the association between changes in oestradiol and follicle-stimulating hormone levels during the menopausal transition and incident diabetes.
  
  
  
  We followed 1407 pre-menopausal women, aged 42-52 years at baseline, who experienced natural menopause, from baseline to the 12thannual follow-up visit in the Study of Women's Health Across the Nation (SWAN). Diabetes was defined based on fasting glucose level, medication use and self-report of physician diagnosis. Cox proportional hazards regression was used to evaluate the associations of incident diabetes with three components of the rate of change in hormones: the intercept (pre-menopausal levels) and two piece-wise slopes representing change during the early and late transition, respectively.
  
  
  
  During 15 years of follow-up, 132 women developed diabetes. After adjusting for potential confounders, a higher oestradiol intercept, but not its rate of change, was borderline significantly associated with lower risk of diabetes [hazard ratio for an interquartile range increase (75.2 pmol/L) 0.53, 95% CI 0.27-1.06]. For follicle-stimulating hormone, a greater rate of increase in the early transition, but not the intercept or late transition, was significantly associated with lower risk of diabetes [hazard ratio for an interquartile range increase (5.9 IU/L/year) 0.31, 95% CI 0.10-0.94].
  
  
  
  Lower pre-menopausal oestradiol levels and a slower rate of follicle-stimulating hormone change during the early transition were associated with higher risk of developing diabetes. Given that obesity plays an important role in diabetes risk and in the levels and changes in oestradiol and follicle-stimulating hormone over the menopausal transition, weight control in earlier mid-life is important to prevent future diabetes development.
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.|Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
authors.forename: S K
authors.identifier: 0000-0001-9981-6250
authors.initials: SK
authors.lastname: Park
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
authors.forename: S D
authors.initials: SD
authors.lastname: Harlow
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.|Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA.
authors.forename: H
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
authors.forename: C
authors.initials: C
authors.lastname: Karvonen-Gutierrez
authors.affiliation: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.|Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Thurston
authors.affiliation: Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
authors.forename: K
authors.initials: K
authors.lastname: Ruppert
authors.affiliation: Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: I
authors.initials: I
authors.lastname: Janssen
authors.affiliation: Division of Reproductive Endocrinology and Infertility, University of Michigan Health System, Ann Arbor, MI, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: Randolph
mesh_terms: D000328:Adult; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000378:metabolism*; D004958:Estradiol / Q000378:metabolism*; D005260:Female; D005640:Follicle Stimulating Hormone / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008593:Menopause / Q000378:metabolism*; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism; D016016:Proportional Hazards Models; D012306:Risk; D014481:United States / Q000453:epidemiology
chemical_list: D004958:Estradiol; D005640:Follicle Stimulating Hormone