DM&RR 2026 - Earlier Menopause and Risk of MASLD (Stokar & Dresner-Pollak)

Tier 1: Established: peer-reviewed research or government health authority
Publisher: Diabetes/Metabolism Research and Reviews (Wiley), vol. 42, 2026; PubMed-indexed · Published: September 5, 2026 · Accessed: September 5, 2026

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• Using the TriNetX global federated network, the study identified women with earlier natural menopause (before age 50) and compared them with similarly aged pre-menopausal women; cases of premature (before 40) or surgical menopause, non-MASLD causes of steatotic liver disease, or sex-hormone therapy were excluded.
• After propensity-score matching for baseline characteristics and metabolic risk factors, the analysis included two matched cohorts of 20,979 women (total n = 41,958), followed for 5 years for new diagnoses of MASLD and its metabolic factors.
• Earlier menopause was associated with an increased risk of developing MASLD: hazard ratio 1.322 (95% CI 1.170-1.492), plus new-onset dyslipidaemia (HR 1.083; 95% CI 1.045-1.122) and pre-diabetes (HR 1.130; 95% CI 1.060-1.205).
• Findings were consistent across stratified analyses by pre-existing metabolic risk factors: HR for MASLD with pre-existing dysglycaemia 1.370 (95% CI 1.042-1.800), dyslipidaemia 1.340 (95% CI 1.053-1.705), hypertension 1.230 (95% CI 0.998-1.516), and overweight 1.280 (95% CI 1.086-1.510).
• Study authors' conclusion: 'Risk of MASLD is increased following menopause before age 50. Further studies should assess the incorporation of menopause timing into female-specific cardiometabolic risk assessment.' The study also notes the prevalence of MASLD in women increases sharply around age 50 years.
• The study addresses a gap: the relationship between an earlier age at natural menopause and MASLD had previously been unknown, even though MASLD is a growing public health concern contributing to liver and cardiovascular complications.