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Long or Highly Irregular Menstrual Cycles as a Marker for Risk of Type 2 Diabetes Mellitus
Abstract
CONTEXT: Although oligomenorrhea has been associated cross-sectionally with insulin resistance and glucose intolerance, it is not known whether oligomenorrhea is a marker for increased future risk of type 2 diabetes mellitus (DM). OBJECTIVE: To prospectively assess risk of type 2 DM in women with a history of long or highly irregular menstrual cycles. DESIGN AND SETTING: The Nurses' Health Study II, a prospective observational cohort study. PARTICIPANTS: A total of 101 073 women who had no prior history of DM and who reported their usual menstrual cycle pattern at age 18 to 22 years on the baseline (1989) questionnaire. MAIN OUTCOME MEASURE: Incident reports of DM, with follow-up through 1997, compared among women categorized by menstrual cycle length (5 categories). RESULTS: During 564 333 person-years of follow-up, there were 507 cases of type 2 DM. Compared with women with a usual cycle length of 26 to 31 days (referent category) at age 18 to 22 years, the relative risk (RR) of type 2 DM among women with a menstrual cycle length that was 40 days or more or was too irregular to estimate was 2.08 (95% confidence interval [CI], 1.62-2.66), adjusting for body mass index at age 18 years and several other potential confounding variables. The RR of type 2 DM associated with long or highly irregular menstrual cycles was greater in obese women, but was also increased in nonobese women (at body mass indexes at age 18 years of <25, 25-29, and >/=30 kg/m, RRs were 1.67 [95% CI, 1.14-2.45], 1.74 [95% CI, 1.07-2.82], and 3.86 [95% CI, 2.33-6.38], respectively). CONCLUSION: Women with long or highly irregular menstrual cycles have a significantly increased risk for developing type 2 DM that is not completely explained by obesity.
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“For this reason, PCOS is associated with a two times increased risk for type 2 diabetes (T2D) [15].”
From From Prediabetes to Type 2 Diabetes Mellitus in Women with Polycystic Ovary Syndrome: Lifestyle and Pharmacological Management (2020) · cites this paper as [15]
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“The menstrual cycle pattern also reflects the endogenous endocrine health environment (2), and irregular menstrual cycles may be a marker of chronic conditions such as diabetes, and polycystic ovary syndrome (PCOS) (16, 17).”
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“Long or highly irregular menstrual cycles, associated with insulin resistance, are a marker for risk of developing type 2 DM that is not entirely explained by obesity [53].”
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Age at menarche, menstrual cycle characteristics and risk of gestational diabetes
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Decreased cord blood estradiol levels in related to mothers with gestational diabetes
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BackgroundMenstrual Cycle Variability and the Likelihood of Achieving Pregnancy
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Hormonal factors and respiratory health in women – a review
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“Furthermore, oligomenorrhea is associated with increased risk for diabetes mellitus (41), cardiovascular diseases (42, 43) and diabetes in pregnancy (44).”
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Breast size and risk of type 2 diabetes mellitus
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BackgroundHypertension is associated with an increased risk for hysterectomy
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Qadri, S., Hussain, A., Bhat, M. H., & Baba, A. A. (2018) · Indian Journal of Psychological Medicine · doi:10.4103/ijpsym.ijpsym_284_17 · Cited by 22
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BackgroundOligomenorrhoea in adolescents with type 1 diabetes mellitus: relationship to glycaemic control
Δελτσίδου, Ά., Lemonidou, C., Zarikas, V., Matziou, V., & Bartsocas, C. S. (2010) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2010.07.027 · Cited by 22
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“Nurses’ Health study II reported that over an 8-year period, the conversion rate to type 2 diabetes among oligomenorrheic women was approximately two-fold greater than that for eumenorrheic women, regardless of whether the oligomenorrheic women were obese or lean, indicating that oligomenorrhea was an independent pred…”
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“For example, women with irregular menses demonstrate an increased risk of DM and CVD (21, 22), an effect the investigators attributed primarily to the predominant role PCOS plays in menstrual dysfunction.”
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“Women with long or highly irregular menstrual cycles have a significantly increased risk for developing type 2 diabetes mellitus.(6) Moreover, menstrual cycle length has also been investigated as a predictor of health outcomes including breast cancer and cardiovascular disease risk factors.”
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“(T2DM), and gestational diabetes mellitus compared with womenwith regular cycles (variously defined as 27-29 or 26-31 days) [1-3].”
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“Women with PCOS are at risk of increased diabetes in later life (Solomon et al., 2001), and those who conceive may have an increased incidence of gestational diabetes.”
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“34 Another large study followed a cohort of 23,571 women for 10 years and reached the same conclusion: irregular menstrual cycles are related to future risk of type 2 diabetes.”
Background
Metadata
- Authors
- Solomon, C. G.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Solomon, Caren G.
- ORCID
- Solomon, Caren G.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2001-11-21
- Volume
- 286
- Issue
- 19
- Pages
- 2421
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2043815784
- Cited by
- 362
- References
- 31
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 11 · 2023: 15 · 2022: 25 · 2021: 23 · 2020: 12 · 2019: 6 · 2018: 15 · 2017: 15 · 2016: 13 · 2015: 14 · 2014: 9 · 2013: 15 · 2012: 23
- FWCI
- 17.24
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (CA50385, R01CA050385)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Keywords
- type 2 diabetes, menstrual cycle length, oligomenorrhea, menstrual irregularity, diabetes risk, obesity, insulin resistance, impaired glucose tolerance, women's health, Nurses' Health Study II
- MeSH terms
- Adult, Diabetes Mellitus, Type 2, Female, Humans, Menstrual Cycle, Obesity, Oligomenorrhea, Prospective Studies, Regression Analysis, Risk Factors, Body Mass Index
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