University of Oulu

Savukoski, Susanna M.; Suvanto, Eila T. J.; Auvinen, Juha P.; Pesonen, Paula R. O.; Keinänen-Kiukaanniemi, Sirkka M.; Puukka, Katri S.; Ebeling, Tapani; Niinimäki, Maarit J. Onset of the climacteric phase by the mid-forties associated with impaired insulin sensitivity: a birth cohort study, Menopause: January 2021 - Volume 28 - Issue 1 - p 70-79. doi: 10.1097/GME.0000000000001658

Onset of the climacteric phase by the mid-forties associated with impaired insulin sensitivity : a birth cohort study

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Author: Savukoski, Susanna M.1,2; Suvanto, Eila TJ.1,2; Auvinen, Juha P.2,3,4;
Organizations: 1Department of Obstetrics and Gynaecology, PEDEGO Research Unit, Oulu University Hospital and University of Oulu, 90029 OYS, Finland
2Medical Research Centre Oulu, Oulu University Hospital and University of Oulu, 90014 Oulu, Finland
3Centre for Life Course Health Research, University of Oulu, 90014 Oulu, Finland
4Oulunkaari Health Centre, Ii, Finland
5Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, 90014 Oulu, Finland
6NordLab Oulu, Oulu University Hospital, 90029 Oulu, Finland
7Department of Clinical Chemistry, University of Oulu, 90014 Oulu, Finland
8Department of Internal Medicine, Oulu University Hospital and University of Oulu, 90029 OYS, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 2.1 MB)
Persistent link:
Language: English
Published: Wolters Kluwer, 2021
Publish Date: 2022-01-31


Objective: To investigate whether the early-onset menopausal transition is associated with deteriorated glucose tolerance in women in their mid-forties.

Methods: A cross-sectional analysis of a cohort study including 2,632 women of the Northern Finland Birth Cohort 1966. The participants were divided into two groups by their menstrual history and follicle-stimulating hormone values at age 46: climacteric and preclimacteric women. Glucose and insulin parameters, as well as mathematical indices derived from them to evaluate insulin sensitivity, were compared between the groups. The results were adjusted for measured body mass index and smoking. The possible effect of hormone therapy was investigated in subanalyses excluding hormone therapy users.

Results: Climacteric women (n = 379) were more often current smokers at age 46 (P = 0.008), and their body mass indices increased more from 31 to 46 years (P = 0.013), compared to preclimacteric women (n = 2,253). In a multivariable generalized linear model, being climacteric at age 46 was associated with several findings suggesting decreased insulin sensitivity: increased glycated hemoglobin (P < 0.001), 2-hour oral glucose tolerance test 30- and 60-minute insulin (P = 0.040 and 0.006, respectively), and area under the insulin curve (P = 0.005). Being climacteric also was associated with a decreased the McAuley (P = 0.024) and Belfiore indices (P = 0.027) and glucose tolerance test 60-minute glucose (P = 0.015). In subanalyses excluding hormone therapy users (n = 94), the results did not change significantly.

Conclusions: Earlier onset of climacteric transition is associated with impaired insulin sensitivity in middle-aged women.

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Series: Menopause
ISSN: 1072-3714
ISSN-E: 1530-0374
ISSN-L: 1072-3714
Volume: 28
Issue: 1
Pages: 70 - 79
DOI: 10.1097/GME.0000000000001658
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: This work was supported by the Northern Ostrobothnia Hospital District, Oulu University Hospital, the University of Oulu, the Finnish Menopause Society, Juho Vainio Foundation, and the Finnish Medical Foundation.
Copyright information: © 2020 The North American Menopause Society. The final authenticated version is available online at