Lactation and Maternal Risk of Type 2 Diabetes: A Population-based Study
Lactation and Maternal Risk of Type 2 Diabetes: A Population-based Study
复制标题
DOI：
10.1016/j.amjmed.2010.03.016
复制
发表时间：
2010-09-01
影响因子：
5.9
通讯作者：
Thom, David
中科院分区：
文献类型：
--
作者：
Schwarz, Eleanor Bimla;Brown, Jeanette S.;Thom, David
背景技术背景：哺乳与母体葡萄糖代谢的改善有关。我们在一个特征明确、具有人群代表性的妇女队列中探讨了哺乳与2型糖尿病风险之间的关系，这些妇女年龄在40-78岁之间，她们是加州一个大型综合医疗保健提供组织的成员，并参加了Kaiser的生殖风险因素研究（RRISK），在2003年到2008年之间。多变量逻辑回归用于控制年龄、产次、种族、教育、子宫切除术、体力活动、吸烟和饮酒、糖尿病家族史和体重指数，同时检查持续时间、排他性和哺乳期的一致性对患2型糖尿病风险的影响。56%的人母乳喂养婴儿≥ 1个月。在完全校正的模型中，持续母乳喂养所有孩子≥ 1个月的女性患2型糖尿病的风险与从未生育过的女性相似（比值比[OR] 1.01; 95%置信区间[CI]，0.56-1.81）。相比之下，从未母乳喂养过婴儿的母亲比未经产的妇女更容易患2型糖尿病（OR 1.92; 95%CI，1.14-3.27）。从未纯母乳喂养的母亲比纯母乳喂养1-3个月的母亲更容易患2型糖尿病（OR 1.52; 95%CI，1.11-2.10）。结论：当足月妊娠后哺乳< 1个月时，2型糖尿病的风险增加，与以后的身体活动和体重指数无关。应鼓励母亲对所有婴儿进行至少一个月的纯母乳喂养。(C)2010年爱思唯尔公司All rights reserved.美国医学杂志（2010）123，863.e1-863.e6
BACKGROUND: Lactation has been associated with improvements in maternal glucose metabolism.METHODS: We explored the relationships between lactation and risk of type 2 diabetes in a well-characterized, population-representative cohort of women, aged 40-78 years, who were members of a large integrated health care delivery organization in California and enrolled in the Reproductive Risk factors for Incontinence Study at Kaiser (RRISK), between 2003 and 2008. Multivariable logistic regression was used to control for age, parity, race, education, hysterectomy, physical activity, tobacco and alcohol use, family history of diabetes, and body mass index while examining the impact of duration, exclusivity, and consistency of lactation on risk of having developed type 2 diabetes.RESULTS: Of 2233 women studied, 1828 were mothers; 56% had breastfed an infant for >= 1 month. In fully adjusted models, the risk of type 2 diabetes among women who consistently breastfed all of their children for >= 1 month remained similar to that of women who had never given birth (odds ratio [OR] 1.01; 95% confidence interval [CI], 0.56-1.81). In contrast, mothers who had never breastfed an infant were more likely to have developed type 2 diabetes than nulliparous women (OR 1.92; 95% CI, 1.14-3.27). Mothers who never exclusively breastfed were more likely to have developed type 2 diabetes than mothers who exclusively breastfed for 1-3 months (OR 1.52; 95% CI, 1.11-2.10).CONCLUSIONS: Risk of type 2 diabetes increases when term pregnancy is followed by < 1 month of lactation, independent of physical activity and body mass index in later life. Mothers should be encouraged to exclusively breastfeed all of their infants for at least 1 month. (C) 2010 Elsevier Inc. All rights reserved. The American Journal of Medicine (2010) 123, 863.e1-863.e6