Menopause factors and alterations in gut microbiota and insulin homeostasis: A cross‐sectional analysis of the microbiome and insulin longitudinal evaluation study ( Microbiome and Insulin Longitudinal Evaluation Study (MILES) )
Authors' conclusion
Menopause age and history of HRT are more strongly associated with insulin resistance than gynaecologic surgery before menopause. However, gynaecologic surgery is associated with shifts in gut microbial composition and plasma metabolite levels with a potential to contribute to future diabetes risk.
Study context
- Population
- Non-diabetic, post-menopausal women, Microbiome and Insulin Longitudinal Evaluation Study (MILES)baseline data
- Participants
- 175 participants
- Exposure
- Menopause-related factors
- Outcome
- Impaired insulin homeostasis (insulin and dysglycaemia indices from 2-h OGTT) as a function of menopause-related factors and gut microbiota dysbiosis
Methodological detailsbaseline data of the MILES cohort, adjusted for covariates
- Baseline data of the MILES cohort
- Adjusted for covariates
Main finding
As reported in the abstract
Matsuda insulin sensitivity index
Menopause age <50 years: lower Matsuda index, β
−0.232 (−0.450, −0.014) (CI)
Hormone replacement therapy (HRT) use: lower Matsuda index, β
−0.275 (−0.444, −0.107) (CI)
Observational data: associations, not effects.
Further findings
Faecal microbiota beta diversity
- Pre-menopausal gynaecologic surgery significantly associated with beta diversity: relative increase in Ruminococcus gnavus and Clostridium species, decrease in Alistipes species and Akkermansia muciniphila
Plasma metabolite mediation
- Reduction in two plasmalogen glycerophospholipids significantly mediated an inverse association between gynaecologic surgery before menopause and insulin sensitivity
Original publication
Menopause factors and alterations in gut microbiota and insulin homeostasis: A cross‐sectional analysis of the microbiome and insulin longitudinal evaluation study ( MILES ). Diabetes Obes Metab. Published 30 July 2025. doi:10.
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