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菲律宾裔美国女性中,与 2 型糖尿病相关的是多胎妊娠,而与内脏脂肪和脂联素无关。

Grand multiparity is associated with type 2 diabetes in Filipino American women, independent of visceral fat and adiponectin.

机构信息

Department of Family and Preventive Medicine, University of California San Diego, San Diego, California, USA.

出版信息

Diabetes Care. 2010 Feb;33(2):385-9. doi: 10.2337/dc09-1477. Epub 2009 Nov 16.

Abstract

OBJECTIVE

To determine whether multiparity is associated with type 2 diabetes, independent of visceral adipose tissue (VAT) and adipokines.

RESEARCH DESIGN AND METHODS

Participants were from the University of California San Diego Filipino Women's Health Study with at least one live birth. A 2-h 75-g oral glucose tolerance test was administered; adiponectin, leptin, ghrelin, reproductive history, family history of diabetes, VAT, and lifestyle behaviors were measured between 1995 and 2002.

RESULTS

Among 152 women, mean age was 59.5 years (range 48-73 years) and mean parity was 4.3 (range 1-12 births). Type 2 diabetes prevalence increased by parity group (low parity, 1-2 births, 25%; medium parity, 3-5 births, 30.3%; and grand multiparity: 6-12 births, 50%; P = 0.048). Family history of diabetes, exercise, insulin resistance, and leptin and ghrelin levels did not differ by parity group. Compared with women in the low parity group, women with > or =6 births were significantly older (62 vs. 57 years), had lower college completion (22 vs. 58%, P = 0.006), more hypertension (72 vs. 55%), higher VAT (74.9 vs. 58.4 cm(3)), and lower adiponectin concentration (5.79 vs. 7.61 microg/ml). In multivariate analysis adjusting for adiponectin, VAT, family history of diabetes, age, education, hypertension, and estrogen use, grand multiparous women had a threefold higher odds of type 2 diabetes (adjusted odds ratio 3.40 [95% CI 1.13-10.2]) compared with low parity women. No differences were observed in the odds of diabetes between women in the medium (1.10 [0.41-2.91]) and low parity groups.

CONCLUSIONS

Having > or =6 children was associated with type 2 diabetes, independent of adiponectin, VAT, family history, and other measured diabetes risk factors.

摘要

目的

确定多胎妊娠是否与 2 型糖尿病有关,而与内脏脂肪组织 (VAT) 和脂肪因子无关。

研究设计和方法

参与者来自加利福尼亚大学圣地亚哥分校菲律宾裔女性健康研究,至少有一次活产。1995 年至 2002 年期间进行了 2 小时 75 克口服葡萄糖耐量试验;测量了脂联素、瘦素、胃饥饿素、生育史、糖尿病家族史、VAT 和生活方式行为。

结果

在 152 名女性中,平均年龄为 59.5 岁(范围 48-73 岁),平均产次为 4.3(范围 1-12 次分娩)。2 型糖尿病的患病率随产次组增加(低产次,1-2 次分娩,25%;中产次,3-5 次分娩,30.3%;多胎产次:6-12 次分娩,50%;P=0.048)。糖尿病家族史、运动、胰岛素抵抗以及瘦素和胃饥饿素水平在产次组之间没有差异。与低产次组相比,产次≥6 次的妇女年龄明显更大(62 岁比 57 岁),大学毕业率较低(22%比 58%,P=0.006),高血压患病率更高(72%比 55%),VAT 更高(74.9 比 58.4cm3),脂联素浓度更低(5.79 比 7.61μg/ml)。在调整脂联素、VAT、糖尿病家族史、年龄、教育程度、高血压和雌激素使用等因素后进行多变量分析,多产次妇女患 2 型糖尿病的风险是低产次妇女的三倍(调整后的优势比 3.40[95%可信区间 1.13-10.2])。而中产次(1.10[0.41-2.91])和低产次妇女之间的糖尿病发病风险没有差异。

结论

生育次数≥6 次与 2 型糖尿病有关,而与脂联素、VAT、家族史和其他测量的糖尿病危险因素无关。

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