Parity and the association with diabetes in older women.
Parity and the association with diabetes in older women.
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DOI：
10.2337/dc10-0015
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发表时间：
2010-08
期刊：
影响因子：
16.2
通讯作者：
Mukamal KJ
中科院分区：
文献类型：
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作者：
Fowler-Brown AG;de Boer IH;Catov JM;Carnethon MR;Kamineni A;Kuller LH;Siscovick DS;Mukamal KJ
研究老年女性产次与糖尿病和葡萄糖稳态标志物的关系。我们使用了心血管健康研究中女性参与者的数据，该研究是一个年龄≥65 岁成年人的纵向队列。这些数据包括对胎次（基线）和空腹血清葡萄糖、胰岛素水平以及药物使用（基线和随访）的评估。我们估计了胎次与基线糖尿病的横截面关系以及胎次与糖尿病发病的关系。在未经调整的分析中，与少产妇女和未生育妇女相比，多产妇女（≥5 次活产）基线时糖尿病患病率较高（25% vs. 12% vs. 15%；P < 0.001）。在控制年龄和种族的回归模型中，多产与糖尿病患病率增加相关（患病率 1.57 [95% CI 1.20–2.06]）；随着模型中加入人口统计和临床因素，相关性被减弱（1.33 [1.00–1.77]）。在包含身体人体测量学的最终模型中，这种关联不再显着（1.21 [0.86–1.49]）。对于那些基线时没有糖尿病的人来说，产次与糖尿病发生或空腹血糖无关。然而，胎次与空腹胰岛素和胰岛素抵抗的稳态评估模型之间存在适度的关联。横断面分析显示，多产与老年女性糖尿病相关。这种关系似乎受到体重变化和胎次状态的社会人口因素的影响和/或调节。在老年非糖尿病女性中，较高的产次不会带来患糖尿病的持续风险。
To examine the relationship of parity with diabetes and markers of glucose homeostasis in older women. We used data from the female participants in the Cardiovascular Health Study, a longitudinal cohort of adults aged ≥65 years. These data included an assessment of parity (baseline) and fasting serum levels of glucose, insulin, and medication use (baseline and follow-up). We estimated both the cross-sectional relationship of parity with baseline diabetes and the relationship of parity with incident diabetes. In unadjusted analyses, women with grand multiparity (≥5 live births) had a higher prevalence of diabetes at baseline compared with those with fewer births and with nulliparous women (25 vs. 12 vs. 15%; P < 0.001). In regression models controlling for age and race, grand multiparity was associated with increased prevalence of diabetes (prevalence ratio 1.57 [95% CI 1.20–2.06]); with addition of demographic and clinical factors to the model, the association was attenuated (1.33 [1.00–1.77]). In final models that included body anthropometrics, the association was no longer significant (1.21 [0.86–1.49]). In those without diabetes at baseline, parity was not associated with incident diabetes or with fasting glucose; however, there was a modest association of parity with fasting insulin and homeostasis assessment model of insulin resistance. Grand multiparity is associated with diabetes in elderly women in cross-sectional analyses. This relationship seems to be confounded and/or mediated by variation in body weight and sociodemographic factors by parity status. In older nondiabetic women, higher parity does not pose an ongoing risk of developing diabetes.