Reproductive risk factors across the female lifecourse and later metabolic health

• Published in: Cell metabolism Vol. 36; no. 2; pp. 240 - 262
• Main Authors: Nichols, Amy R., Chavarro, Jorge E., Oken, Emily
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 06.02.2024
• Subjects: diabetes; Diabetes Mellitus, Type 2 - complications; Dyslipidemias; Female; Humans; metabolic dysfunction; Obesity - complications; PCOS; Polycystic Ovary Syndrome - complications; Polycystic Ovary Syndrome - drug therapy; pregnancy; Risk Factors; risk factors; PCOS; diabetes; pregnancy; metabolic dysfunction
• ISSN: 1550-4131; 1932-7420
• DOI: 10.1016/j.cmet.2024.01.002

Metabolic health is characterized by optimal blood glucose, lipids, cholesterol, blood pressure, and adiposity. Alterations in these characteristics may lead to the development of type 2 diabetes mellitus or dyslipidemia. Recent evidence suggests that female reproductive characteristics may be overlooked as risk factors that contribute to later metabolic dysfunction. These reproductive traits include the age at menarche, menstrual irregularity, the development of polycystic ovary syndrome, gestational weight change, gestational dysglycemia and dyslipidemia, and the severity and timing of menopausal symptoms. These risk factors may themselves be markers of future dysfunction or may be explained by shared underlying etiologies that promote long-term disease development. Disentangling underlying relationships and identifying potentially modifiable characteristics have an important bearing on therapeutic lifestyle modifications that could ease long-term metabolic burden. Further research that better characterizes associations between reproductive characteristics and metabolic health, clarifies underlying etiologies, and identifies indicators for clinical application is warranted in the prevention and management of metabolic dysfunction. Female reproductive characteristics may be overlooked as contributors to lifecourse metabolic dysfunction. Whether these characteristics are markers of future dysfunction or share underlying etiologies, disentangling these relationships may provide direction for therapeutic lifestyle modifications that could improve long-term metabolic burden.