PMID- 34475032
OWN - NLM
STAT- MEDLINE
DCOM- 20220307
LR  - 20221029
IS  - 1935-5548 (Electronic)
IS  - 0149-5992 (Print)
IS  - 0149-5992 (Linking)
VI  - 44
IP  - 11
DP  - 2021 Nov
TI  - Early Menopause and Cardiovascular Disease Risk in Women With or Without Type 2 
      Diabetes: A Pooled Analysis of 9,374 Postmenopausal Women.
PG  - 2564-2572
LID - 10.2337/dc21-1107 [doi]
AB  - OBJECTIVE: Early menopause may be associated with higher cardiovascular disease 
      (CVD) risk. Type 2 diabetes mellitus (T2DM), coupled with early menopause, may 
      result in even greater CVD risk in women. We examined CVD risk in women with 
      early compared with normal-age menopause, with and without T2DM overall, and by 
      race/ethnicity. RESEARCH DESIGN AND METHODS: We pooled data from the 
      Atherosclerosis Risk in Communities study, the Multi-Ethnic Study of 
      Atherosclerosis, and the Jackson Heart Study. We included women with data on 
      menopausal status, menopausal age, and T2DM, excluding pre- or perimenopausal 
      women and those with prevalent CVD. Outcomes included incident coronary heart 
      disease (CHD), stroke, heart failure (HF), and atherosclerotic cardiovascular 
      disease (ASCVD) (CHD or stroke). We estimated the risk associated with early (<45 
      years) compared with normal-age menopause using Cox proportional hazards models. 
      Covariates included age, race/ethnicity, education, BMI, blood pressure, 
      cholesterol, smoking, alcohol consumption, antihypertensive medication, 
      lipid-lowering medication, hormone therapy use, and pregnancy history. RESULTS: 
      We included 9,374 postmenopausal women for a median follow-up of 15 years. We 
      observed 1,068 CHD, 659 stroke, 1,412 HF, and 1,567 ASCVD events. T2DM 
      significantly modified the effect of early menopause on CVD risk. Adjusted hazard 
      ratios for early menopause and the outcomes were greater in women with T2DM 
      versus those without (CHD 1.15 [95% CI 1.00, 1.33] vs. 1.09 [1.03, 1.15]; stroke 
      1.21 [1.04, 1.40] vs. 1.10 [1.04, 1.16]; ASCVD 1.29 [1.09, 1.51] vs. 1.10 [1.04, 
      1.17]; HF 1.18 [1.00, 1.39] vs. 1.09 [1.03, 1.16]). The modifying effect of T2DM 
      on the association between early menopause and ASCVD was only statistically 
      significant in Black compared with White women. CONCLUSIONS: Early menopause was 
      associated with an increased risk for CVD in postmenopausal women. T2DM may 
      further augment the risk, particularly in Black women.
CI  - (c) 2021 by the American Diabetes Association.
FAU - Yoshida, Yilin
AU  - Yoshida Y
AUID- ORCID: 0000-0003-0441-2697
AD  - Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane 
      University School of Medicine, New Orleans, LA yyoshida1@tulane.edu.
AD  - Southeast Louisiana VA Medical Center, New Orleans, LA.
AD  - Tulane Center of Excellence in Sex-Based Biology and Medicine, Tulane University 
      School of Medicine, New Orleans, LA.
FAU - Chen, Zhipeng
AU  - Chen Z
AD  - Department of Biostatistics and Data Science, Tulane University School of Public 
      Health and Tropical Medicine, New Orleans, LA.
FAU - Baudier, Robin L
AU  - Baudier RL
AD  - Department of Epidemiology, Tulane University School of Public Health and 
      Tropical Medicine, New Orleans, LA.
FAU - Krousel-Wood, Marie
AU  - Krousel-Wood M
AD  - Department of Epidemiology, Tulane University School of Public Health and 
      Tropical Medicine, New Orleans, LA.
AD  - Section of General Internal Medicine, Deming Department of Medicine, Tulane 
      University School of Medicine, New Orleans, LA.
FAU - Anderson, Amanda H
AU  - Anderson AH
AD  - Department of Epidemiology, Tulane University School of Public Health and 
      Tropical Medicine, New Orleans, LA.
FAU - Fonseca, Vivian A
AU  - Fonseca VA
AUID- ORCID: 0000-0002-3381-7151
AD  - Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane 
      University School of Medicine, New Orleans, LA.
AD  - Southeast Louisiana VA Medical Center, New Orleans, LA.
FAU - Mauvais-Jarvis, Franck
AU  - Mauvais-Jarvis F
AUID- ORCID: 0000-0002-0874-0754
AD  - Section of Endocrinology and Metabolism, Deming Department of Medicine, Tulane 
      University School of Medicine, New Orleans, LA.
AD  - Southeast Louisiana VA Medical Center, New Orleans, LA.
AD  - Tulane Center of Excellence in Sex-Based Biology and Medicine, Tulane University 
      School of Medicine, New Orleans, LA.
LA  - eng
SI  - figshare/10.2337/figshare.15135006
GR  - I01 BX003725/BX/BLRD VA/United States
GR  - R01 DK074970/DK/NIDDK NIH HHS/United States
GR  - K12 HD043451/HD/NICHD NIH HHS/United States
GR  - U54 GM104940/GM/NIGMS NIH HHS/United States
GR  - P20 GM109036/GM/NIGMS NIH HHS/United States
GR  - R01 DK107444/DK/NIDDK NIH HHS/United States
GR  - R01 DK107566/DK/NIDDK NIH HHS/United States
GR  - R01 DK104730/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20210902
PL  - United States
TA  - Diabetes Care
JT  - Diabetes care
JID - 7805975
SB  - IM
MH  - *Atherosclerosis/complications
MH  - *Cardiovascular Diseases/epidemiology/etiology
MH  - Child, Preschool
MH  - *Coronary Disease/complications
MH  - *Diabetes Mellitus, Type 2/complications/epidemiology
MH  - Female
MH  - Humans
MH  - Menopause
MH  - Postmenopause
MH  - Risk Factors
PMC - PMC8546283
EDAT- 2021/09/04 06:00
MHDA- 2022/03/08 06:00
PMCR- 2021/09/02
CRDT- 2021/09/03 05:57
PHST- 2021/05/22 00:00 [received]
PHST- 2021/08/03 00:00 [accepted]
PHST- 2021/09/04 06:00 [pubmed]
PHST- 2022/03/08 06:00 [medline]
PHST- 2021/09/03 05:57 [entrez]
PHST- 2021/09/02 00:00 [pmc-release]
AID - dc21-1107 [pii]
AID - 211107 [pii]
AID - 10.2337/dc21-1107 [doi]
PST - ppublish
SO  - Diabetes Care. 2021 Nov;44(11):2564-2572. doi: 10.2337/dc21-1107. Epub 2021 Sep 
      2.