Reproductive factors and risk of type 2 diabetes in an occupational cohort of Chinese women

Abstract Aims Hormonal milieu has long been known to play an important role in the development of type 2 diabetes (T2D). The aims of this study are to investigate the roles of menstrual and reproductive factors in relation to T2D risk in an occupational cohort of Chinese women; and to explore the role of endogenous estrogen in T2D development. Methods We conducted a cross-sectional analysis of baseline data from 16114 women (11051 premenopausal and 5063 postmenopausal) aged ≥20years who participated in the ongoing prospective occupational cohort study. Multivariable logistic regressions were modeled to evaluate the associations of reproductive factors with T2D risk. Results Early menarche at age (≤12 versus 15–16 years) was associated with increased T2D risk (odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.16–2.22). After multiple adjustment including age, BMI and occupation, postmenopausal status was positively associated with T2D risk (OR: 1.54, 95% CI: 1.10–2.14). Reproductive life span was significantly associated with T2D risk ( P =0.02), albeit displaying a U-shape relationship. Similarly, age at menopause was also associated with T2D risk in the same U-shaped as with reproductive life span ( P =0.03). Further, years since menopause ( P =0.003), but not history of cycle regularity and hormone use, was associated with increased T2D risk. Conclusion Reproductive factors were associated with T2D supporting the notion that either a short or prolonged exposure to endogenous estrogen affects T2D risk in Chinese women. Reproductive factors should be added to risk stratification when counseling women about their risk of developing diabetes.