Role of plasma metabolomics in the association of age at menopause with premature mortality. (A) Mediation effect of metabolomic signature on the earlier age at menopauseāpremature mortality association. After adjusting for age, race, education, employment, BMI, healthy alcohol intake, healthy diet, healthy physical activity, and menopause hormone therapy, the total and direct effects of an earlier age at menopause on the risk of premature mortality and the mediated proportion of the metabolomic signature are shown, with 95% CIs for the effect estimates provided in parentheses. * p-value < 0.05. (B) Venn diagram for metabolites correlating with age at menopause and premature mortality. The diagram illustrates the number of metabolites associated with an earlier age at menopause (13 metabolites) or with an premature mortality (41 metabolites), and those intersecting both conditions (93 metabolites).