---
title: "Endogenous Oestrogen Exposure and Type 2 Diabetes Risk in Women: Long-Term Population Study"
id: "pubmed-42673573"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42673573"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42673573/"
doi: "10.1002/edm2.70267"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Endogenous Oestrogen Exposure and Type 2 Diabetes Risk in Women: Long-Term Population Study
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42673573
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42673573/)
- **DOI:** [10.1002/edm2.70267](https://doi.org/10.1002%2Fedm2.70267)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This population-based cohort study evaluated the association between **endogenous oestrogen exposure (EEE)** duration and incidence of **type 2 diabetes (T2D)** in women followed for about two decades. - At baseline 6,273 post-menarche women aged >20 years were considered; after exclusions, 3,411 women remained (2,754 premenopausal and 657 menopausal). - Mean participant age was 39.3 years (SD 12.5); mean age at menarche was 13.5 years (SD 1.5). - Over follow-up, 1,053 women (30.9%) developed diabetes: 819 (29.7%) among premenopausal and 234 (35.6%) among menopausal participants. - EEE was quantified per participant and converted into a z-score; Cox proportional hazards models estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for T2D per 1-SD increase in EEE z-score. - In age- and BMI-adjusted models, higher EEE z-score was inversely associated with T2D incidence (HR 0.91, 95% CI 0.85–0.97), indicating a 9% lower risk per 1-SD increase in EEE. - After full adjustment for potential confounders, the inverse association persisted (HR 0.90, 95% CI 0.84–0.96). - The authors conclude that longer duration of **endogenous oestrogen exposure** may be associated with a reduced risk of developing **T2D**, underscoring reproductive history as a factor in risk assessment. - The report lists keywords including endogenous oestrogen, menarche, menopause, and incidence of diabetes mellitus; full reference and DOI are provided in the source.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. * 2 Foundation for Research & Education Excellence, Vestavia Hills, Al, USA. * 3 Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. * 4 Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. * PMID: **42673573** * DOI: [ 10.1002/edm2.70267 ](https://doi.org/10.1002/edm2.70267) Item in Clipboard # Diabetes Type 2 in Women: The Impact of EndogenousOestrogen, A Population-Based Study With About 2 Decades of Follow-Up Fahimeh Ramezani Tehrani et al. Endocrinol Diabetes Metab. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Endocrinol Diabetes Metab Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Endocrinol+Diabetes+Metab%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Endocrinol+Diabetes+Metab%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42673573/) . 2026 Sep;9(5):e70267. doi: 10.1002/edm2.70267. ### Authors [Fahimeh Ramezani Tehrani](https://pubmed.ncbi.nlm.nih.gov/?term=Ramezani+Tehrani+F&cauthor_id=42673573)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-1 "Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-2 "Foundation for Research & Education Excellence, Vestavia Hills, Al, USA."), [Maryam Mousavi](https://pubmed.ncbi.nlm.nih.gov/?term=Mousavi+M&cauthor_id=42673573)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-1 "Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran."), [Mahbanoo Farhadi-Azar](https://pubmed.ncbi.nlm.nih.gov/?term=Farhadi-Azar+M&cauthor_id=42673573)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-1 "Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran."), [Fatemeh Mahboobifard](https://pubmed.ncbi.nlm.nih.gov/?term=Mahboobifard+F&cauthor_id=42673573)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-3 "Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran."), [Fereidoun Azizi](https://pubmed.ncbi.nlm.nih.gov/?term=Azizi+F&cauthor_id=42673573)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-4 "Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran."), [Maryam Farahmand](https://pubmed.ncbi.nlm.nih.gov/?term=Farahmand+M&cauthor_id=42673573)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42673573/#short-view-affiliation-1 "Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.") ### Affiliations * 1 Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. * 2 Foundation for Research & Education Excellence, Vestavia Hills, Al, USA. * 3 Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. * 4 Endocrine Research Center, Research Institute for Endocrine Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran. * PMID: **42673573** * DOI: [ 10.1002/edm2.70267 ](https://doi.org/10.1002/edm2.70267) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Aims:** The role of endogenous oestrogen exposure (EEE) in type 2 diabetes (T2D) remains understudied despite its potential importance. This study aimed to assess T2D incidence in women with different endogenous oestrogen durations. **Materials and methods:** At the initiation of the study, 6273 post-menarche women above 20 years were included. After applying the exclusion criteria, 3,411 women remained (2,754 premenopausal and 657 menopausal). Each woman's EEE was determined, and they were monitored for the incidence of T2D. Based on the EEE duration, hazard ratios (HRs) and 95% confidence intervals (CI) for the T2D event were reported using Cox proportional hazards regression models. **Results:** The mean age and menarcheal age (standard deviation) of participants were 39.3(12.5) and 13.5(1.5) years, respectively. Finally, 30.9% (1053) of the women developed diabetes (819 (29.7%) premenopausal and 234 (35.6%) menopausal). The age and BMI-adjusted model's findings indicated that, overall, the EEE z-score was inversely associated with T2D incidence in postmenarcheal women [HR 0.91, 95% CI 0.85-0.97], meaning that the risk of T2D decreased by 9% for every 1-SD increase in the EEE z-score. Furthermore, after full adjustment for potential confounders, the association remained statistically significant (HR = 0.90, 95% CI: 0.84-0.96). **Conclusions:** The findings suggest that longer EEE duration may reduce the risk of T2D, emphasising the importance of reproductive history in health assessments. **Keywords:** endogenous oestrogen; menarche; menopause; the incidence of diabetes mellitus. © 2026 The Author(s). Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## References 1. 1. M. Zamani, H. Khoubfekr, A. Namdar, S. Rezaei, and V. Rahmanian, “The Association Between Nutrition Style Through the First 2 Years of Life, Maternal and Childhood Indicators With Type 1 Diabetes Mellitus in Children: A Case‐Control Study,” Journal of Nutrition and Food Security 8 (2023): 17–26. 2. 1. Collaborators, G.M.D., “Global, Regional, and National Burden of 12 Mental Disorders in 204 Countries and Territories, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019,” Lancet Psychiatry 9 (2022): 137–150. 3. 1. National Institute of Health Researches of Iran, “Atlas of STEPwise Approach to Noncommunicable Disease (NCD) Risk Factor Surveillance (STEPs) 2021, S., 2022”. 4. 1. M. Javanbakht, A. Mashayekhi, H. R. Baradaran, A. Haghdoost, and A. Afshin, “Projection of Diabetes Population Size and Associated Economic Burden Through 2030 in Iran: Evidence From Micro‐Simulation Markov Model and Bayesian Meta‐Analysis,” PLoS One 10 (2015): e0132505. 5. 1. D. J. Magliano, E. J. Boyko, and I. D. Atlas, “What Is Diabetes?,” in IDF DIABETES ATLAS, 10th ed. (International Diabetes Federation, 2021). 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