Kim Jin Hwi, Lee Sung Jong
1Department of Obstetrics and Gynecology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea 2Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Menopause. 2017 Jul;24(7):832-837. doi: 10.1097/GME.0000000000000846.
The objective of this study was to assess the association between parity and insulin resistance in nondiabetic, postmenopausal women.
This cross-sectional study was conducted using data from the 2010 Korean National Health and Nutrition Examination Survey administered by the Korean Ministry of Health and Welfare. A total of 1,243 nondiabetic postmenopausal women were included in this study and subdivided into three groups according to parity (1-2, 3-4, and ≥5 live births). Insulin resistance was measured using the homeostasis model assessment of insulin resistance (HOMA-IR) index. The relationship between parity and insulin resistance was investigated using analysis of covariance.
HOMA-IR showed a positive relationship with parity. Mean HOMA-IR (geometric mean and 95% CI) increased according to increasing parity group (1-2, 3-4, and ≥5 live births) after adjustment for age, smoking, alcohol consumption, exercise, education, income, and body mass index as follows: 2.1 (2.0-2.2) < 2.2 (2.1-2.3) < 2.5 (2.2-2.8) (P = 0.040 and P for trend = 0.012). In addition, this positive association was more apparent when insulin resistance was accompanied by obesity. The mean parity of the obese and insulin-resistant group was significantly higher than that of the nonobese insulin-sensitive group (3.6 ± 0.1 vs 3.2 ± 0.1, P = 0.047).
Our study provides the first evidence that parity is significantly associated with insulin resistance in nondiabetic postmenopausal women. Further prospective longitudinal studies are needed to confirm the impact of parity on insulin resistance.
本研究旨在评估非糖尿病绝经后女性的生育次数与胰岛素抵抗之间的关联。
本横断面研究使用了韩国卫生与福利部进行的2010年韩国国家健康与营养检查调查的数据。本研究共纳入1243名非糖尿病绝经后女性，并根据生育次数（1 - 2次、3 - 4次和≥5次活产）分为三组。使用胰岛素抵抗稳态模型评估（HOMA - IR）指数测量胰岛素抵抗。采用协方差分析研究生育次数与胰岛素抵抗之间的关系。
HOMA - IR与生育次数呈正相关。在调整年龄、吸烟、饮酒、运动、教育、收入和体重指数后，HOMA - IR的均值（几何均值和95%可信区间）随着生育次数组的增加（1 - 2次、3 - 4次和≥5次活产）而升高，具体如下：2.1（2.0 - 2.2）＜2.2（2.1 - 2.3）＜2.5（2.2 - 2.8）（P = 0.040，趋势P = 0.012）。此外，当胰岛素抵抗伴有肥胖时，这种正相关更为明显。肥胖且胰岛素抵抗组的平均生育次数显著高于非肥胖胰岛素敏感组（3.6±0.1对3.2±0.1，P = 0.047）。
我们的研究首次提供证据表明，生育次数与非糖尿病绝经后女性的胰岛素抵抗显著相关。需要进一步的前瞻性纵向研究来证实生育次数对胰岛素抵抗的影响。
