ABSTRACT
Background@#Estrogen promotes glucose homeostasis, enhances insulin sensitivity, and maintains counterregulatory responses in recurrent hypoglycemia in women of reproductive age. Postmenopausal women with type 2 diabetes mellitus (T2DM) might be more vulnerable to severe hypoglycemia (SH) events. However, the relationship between reproductive factors and SH occurrence in T2DM remains unelucidated. @*Methods@#This study included data on 181,263 women with postmenopausal T2DM who participated in a national health screening program from January 1 to December 31, 2009, obtained using the Korean National Health Insurance System database. Outcome data were obtained until December 31, 2018. Associations between reproductive factors and SH incidence were assessed using Cox proportional hazards models. @*Results@#During the mean follow-up of 7.9 years, 11,279 (6.22%) postmenopausal women with T2DM experienced SH episodes. A longer reproductive life span (RLS) (≥40 years) was associated with a lower SH risk compared to a shorter RLS (<30 years) (adjusted hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.69 to 0.80; P for trend <0.001) after multivariable adjustment. SH risk decreased with every 5-year increment of RLS (with <30 years as a reference [adjusted HR, 0.91; 95% CI, 0.86 to 0.95; P=0.0001 for 30−34 years], [adjusted HR, 0.80; 95% CI, 0.76 to 0.84; P<0.001 for 35−39 years], [adjusted HR, 0.74; 95% CI, 0.68 to 0.81; P<0.001 for ≥40 years]). The use of hormone replacement therapy (HRT) was associated with a lower SH risk than HRT nonuse. @*Conclusion@#Extended exposure to endogenous ovarian hormone during lifetime may decrease the number of SH events in women with T2DM after menopause.
ABSTRACT
BACKGROUND: Several studies have revealed the frequency of family mealtimes to be inversely associated with depressive symptoms in adolescents. However, there have been few studies in older populations. This cross-sectional study investigated the association between family mealtime frequency and depressive symptoms in elderly Koreans. METHODS: This study analyzed 4,959 elderly men and women (aged 65 years or older) who participated in the Korea National Health and Nutrition Examination Survey. Self-administered questionnaires were used to assess depressive status, family mealtime frequency, and covariates. Multiple logistic regression analysis was performed to evaluate the association using the eating alone group as a reference. RESULTS: After adjusting for all covariates, participants who had family meals 3 times a day had fewer depressive symptoms than the eating alone group; adjusted odds ratios (ORs) (95% confidence intervals [CIs]) were 0.72 (0.58–0.89) for point depressiveness/anxiety and 0.73 (0.56–0.94) for depressiveness lasting for at least 2 weeks. In suicidal ideation, the OR (95% CI) of eating with family twice a day was significant after full adjusting for covariates at 0.67 (0.50–0.88). CONCLUSION: Family mealtimes were closely associated with depressive symptoms in elderly Koreans, which suggests that maintaining intrafamilial bonding is important for mental health in an older population.