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口服避孕药对绝经后女性糖尿病患病率的长期影响:2007 - 2012年韩国国家健康与营养检查调查(KNHANES)

Long-term effects of oral contraceptives on the prevalence of diabetes in post-menopausal women: 2007-2012 KNHANES.

作者信息

Kim Sung-Woo, Jeon Jae-Han, Lee Won-Kee, Lee Sungwoo, Kim Jung-Guk, Lee In-Kyu, Park Keun-Gyu

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Cha Gumi Medical Center, Cha University School of Medicine, Gumi, South Korea.

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea.

出版信息

Endocrine. 2016 Sep;53(3):816-22. doi: 10.1007/s12020-016-0972-z. Epub 2016 May 9.

Abstract

There is little information on whether past use of oral contraceptives (OCs) at child-bearing age influences the incidences of diabetes and insulin resistance (IR) after menopause. This study aimed to evaluate the association of past use of OCs with the development of diabetes and IR in post-menopausal women. This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey carried out from 2007 to 2012. Of the 50405 participants, 6554 post-menopausal women were included in the analysis. The associations of OC use with the prevalence of diabetes in post-menopausal women were examined using multivariate logistic analysis. In addition, fasting glucose and insulin levels were measured in 3338 nondiabetic post-menopausal women, and the association between IR and OCs was examined by the analysis of covariance. The prevalence of diabetes was significantly higher in post-menopausal participants who had taken OCs for more than 6 months than in those who had never taken OCs. The association remained significant after adjusting for multiple confounding factors (odd ratio 1.379; 95 % CI 1.115-1.707; P = 0.003). The duration of OC use was also positively associated with the prevalence of diabetes. Furthermore, taking OCs for more than 6 months led to a significant increase in fasting insulin levels and HOMA-IR in nondiabetic participants. Past use of OCs for more than 6 months led to a significant increase in the prevalence of diabetes in post-menopausal women, and increased IR in nondiabetic participants. These results suggested that the prolonged use of OCs at reproductive age may be an important risk factor for developing diabetes in post-menopausal women.

摘要

关于育龄期口服避孕药(OCs)的既往使用情况是否会影响绝经后糖尿病和胰岛素抵抗(IR)的发生率,目前相关信息较少。本研究旨在评估OCs的既往使用情况与绝经后女性糖尿病及IR发生发展之间的关联。这项横断面研究基于2007年至2012年开展的韩国国家健康与营养检查调查的数据。在50405名参与者中,6554名绝经后女性被纳入分析。采用多因素逻辑回归分析来检验OCs使用与绝经后女性糖尿病患病率之间的关联。此外,对3338名非糖尿病绝经后女性测量了空腹血糖和胰岛素水平,并通过协方差分析来检验IR与OCs之间的关联。服用OCs超过6个月的绝经后参与者中糖尿病患病率显著高于从未服用过OCs的参与者。在调整多个混杂因素后,这种关联仍然显著(比值比1.379;95%可信区间1.115 - 1.707;P = 0.003)。OCs的使用时长也与糖尿病患病率呈正相关。此外,在非糖尿病参与者中,服用OCs超过6个月会导致空腹胰岛素水平和稳态模型评估胰岛素抵抗(HOMA - IR)显著升高。既往服用OCs超过6个月会导致绝经后女性糖尿病患病率显著增加,并使非糖尿病参与者的IR升高。这些结果表明,育龄期长期使用OCs可能是绝经后女性患糖尿病的一个重要危险因素。

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