Department of Family and Preventive Medicine, University of California San Diego, San Diego, California, USA.
Diabetes Care. 2010 Feb;33(2):385-9. doi: 10.2337/dc09-1477. Epub 2009 Nov 16.
To determine whether multiparity is associated with type 2 diabetes, independent of visceral adipose tissue (VAT) and adipokines.
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.
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.
Having > or =6 children was associated with type 2 diabetes, independent of adiponectin, VAT, family history, and other measured diabetes risk factors.
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。
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。
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。
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。