Simmons D, Shaw J, McKenzie A, Eaton S, Cameron A J, Zimmet P
University of Auckland Waikato Clinical School, Waikato Hospital, Private Bag 3200, Pembroke Street, Hamilton, New Zealand.
Diabetologia. 2006 Jul;49(7):1522-7. doi: 10.1007/s00125-006-0276-6. Epub 2006 May 11.
AIMS/HYPOTHESIS: We sought to determine the risk of diabetes and IGT/IFG with grand multiparity.
SUBJECTS, MATERIALS AND METHODS: Women, aged > or =25 years, from the Australian Diabetes, Obesity and Lifestyle Study and the Crossroads Undiagnosed Disease Study (a rural study in Victoria, Australia), participated in a household census (response 67 and 70%, respectively), subsequently attending a biomedical examination that included an oral glucose tolerance test (58% [6198] and 69% [819]).
After adjusting for age, obesity and socio-economic status, diabetes, but not IGT/IFG, was less common among women with a parity of 1 to 2 (odds ratio [OR]=0.64 [0.48-0.84]) and 3 to 4 (OR=0.72 [0.53-0.96]) than in grand multiparous women. This relationship was unrelated to past hysterectomy, use of the oral contraceptive pill or menopausal status.
CONCLUSIONS/INTERPRETATION: Grand multiparity is associated with an increased risk of diabetes but not of IGT/IFG. We postulate that parity accelerates transition from IGT/IFG to diabetes, more than it does transition from normal glucose tolerance to IGT/IFG.
目的/假设:我们试图确定多产与糖尿病以及糖耐量受损/空腹血糖受损的风险。
受试者、材料与方法:来自澳大利亚糖尿病、肥胖与生活方式研究以及十字路口未确诊疾病研究(澳大利亚维多利亚州的一项农村研究)的年龄≥25岁的女性参与了家庭普查(应答率分别为67%和70%),随后参加了包括口服葡萄糖耐量试验在内的生物医学检查(分别为58%[6198人]和69%[819人])。
在对年龄、肥胖和社会经济状况进行校正后,与多产女性相比,产次为1至2次(比值比[OR]=0.64[0.48 - 0.84])和3至4次(OR=0.72[0.53 - 0.96])的女性中糖尿病较为少见,但糖耐量受损/空腹血糖受损并非如此。这种关系与既往子宫切除术、口服避孕药的使用或绝经状态无关。
结论/解读:多产与糖尿病风险增加相关,但与糖耐量受损/空腹血糖受损风险无关。我们推测,产次加速从糖耐量受损/空腹血糖受损向糖尿病的转变,比从正常糖耐量向糖耐量受损/空腹血糖受损的转变更为明显。