Highlights
- •The relationships between reproductive lifespan and incident metabolic diseases are unclear.
- •This systematic review found that a short reproductive lifespan is associated with a higher risk of type 2 diabetes, with a 6–15% higher risk for a one-year decrease in reproductive lifespan.
- •It remains to be seen what factors mediate this effect of reproductive lifespan on the risk of incident metabolic diseases across adulthood.
ABSTRACT
Some reproductive factors are found to be associated with metabolic outcomes in women;
however, little is known about reproductive lifespan characteristics and the mutual
effect of age at menarche and age at menopause on cardiovascular risk. This systematic
review evaluated reproductive lifespan characteristics and describes the mutual effect
of age at menarche and age at menopause on the risk of type 2 diabetes (T2DM) and
hypertension at midlife. PubMed, EMBASE, and Web of Science were screened for studies
published up to September 1, 2020. The individual effect estimates were reviewed and
synthesized without meta-analysis due to methodological and clinical or conceptual
diversity in reported studies. Of the 3033 identified studies, 20 were included in
the final synthesis: 6 reported reproductive life span; 12 reported age at menarche,
and 7 reported age at menopause. Synthesis of two cohorts, with a median follow-up
of 9–11 years, showed that a shorter reproductive lifespan was positively associated
with T2DM, yielding 6–15% higher risk of T2DM for a one-year decrease in reproductive
lifespan. A few studies also demonstrated that women who experienced early menarche
(four of six studies) and early menopause (two of five studies) were positively associated
with risk of T2DM. The association between reproductive lifespan and hypertension
was unclear due to the limited availability of studies. Our findings suggest that
a shorter reproductive lifespan is associated with T2DM risk in postmenopausal women,
especially those with early menarche and early menopause. Large cohort studies are
needed to assess the association between reproductive lifespan and incident hypertension
in midlife.
Keywords
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Article info
Publication history
Published online: September 22, 2021
Accepted:
September 19,
2021
Received in revised form:
August 16,
2021
Received:
February 7,
2021
Identification
Copyright
© 2021 Elsevier B.V. All rights reserved.
