Endocrine Abstracts (2018) 63 OC11.1 | DOI: 10.1530/endoabs.63.OC11.1

Hormonal factors and type 2 diabetes risk in women: a 22 year follow-up study on more than 83 000 women from the E3N cohort study

Sopio Tatulashvili1, Gaelle Gusto2, Beverley Balkau3, Emmanuel Cosson1, Fabrice Bonnet4, Hélène Bihan1 & Guy Fagherazzi2


1Endocrinology, Diabetes and Metabolic Diseases Unit, Avicenne Hospital, APHP, Bobigny, France; 2Centre for Research in Epidemiology and Population Health (CESP) ‘Health across Generations’ team, University Paris-Saclay, Villejuif, France; 3Centre for Research in Epidemiology and Population Health (CESP) ‘Health across Generations’ team, Université Paris-Saclay, Villejuif, France; 4Université de Rennes 1, Department of Endocrinology, Diabetology and Nutrition, Rennes, France.


Background: Early screening and the treatment of glucose metabolism disorders could lower the risk of further complications. For this purpose it is important to identify the risk factors of type 2 diabetes mellitus (T2DM). The aim of this study was to determine the association between various hormonal factors and the risk of incident type 2 diabetes in the large prospective female E3N cohort study.

Material and methods: The study included 83,799 French women from the Etude Epidemiologique de Femmes de la Mutuelle Générale de l’Education Nationale (E3N) prospective cohort followed between 1992 and 2014. Cox multivariable models adjusted for the main T2DM risk factors were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) between various hormonal factors and T2DM risk.

Results: We observed that the elevated age at menarche (HR=0.88 [0.81–0.95]), the younger age at first term pregnancy (HR =0.90 [0.82–0.98]), breastfeeding (HR =0.90 [0.85–0.95]), the elevated number of total menstrual cycles (HR =0.75 [0.68–0.82]), the elevated age at menopause (HR=0.70 [0.63–0.78]) and the elevated duration of sex hormone exposure (HR=0.66 [0.61–0.73]) was associated with a lower risk of type 2 diabetes. While, the use of contraceptive pills (HR =1.33 [1.25–1.42]) and the elevated duration of menstrual cycles (HR =1.23 [1.07–1.41]) was associated with the elevated risk of type 2 diabetes.

Conclusion: It seems that longer exposure to sex hormones but later in life could reduce diabetes. Risk induced by oral contraceptives could lead to personalized advice for young women at risk.

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