Supplementary information files for Ethnic differences in the association between age at natural menopause and risk of type 2 diabetes mellitus among postmenopausal women: a pooled analysis of individual data from 13 cohort studies

Supplementary files for article Ethnic differences in the association between age at natural menopause and risk of type 2 diabetes mellitus among postmenopausal women: a pooled analysis of individual data from 13 cohort studiesObjective: To investigate associations between age at natural menopause, particularly premature ovarian insufficiency (POI; natural menopause before 40 years), and incident type 2 diabetes (T2DM) and identify any variations by ethnicity.Research design and methods: We pooled individual-level data of 338,059 women from 13 cohort studies without T2DM before menopause, with six ethnic groups: White (n=177,674), Chinese (n=146,008), Japanese (n=9,061), South/Southeast Asian (n=2,228), Black (n=1,838), and Mixed/Other (n=1,250). Hazard ratios (HRs) of T2DM associated with age at menopause were estimated in the overall sample and by ethnicity, with study as a random effect. For each ethnic group, we further stratified the association by birth year, education level, and BMI.Results: Over nine years of follow-up, 20,064 (5.9%) women developed T2DM. Overall, POI (vs menopause at 50-51 years) was associated with an increased risk of T2DM (HR:1.31, 1.20-1.44), while there was an interaction between age at menopause and ethnicity (pConclusions: POI and early menopause are risk factors for T2DM in postmenopausal women, with considerable variation across ethnic groups, and may need to be considered in risk assessments of T2DM among women.