Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
Menopause. 2019 Sep;26(9):1010-1015. doi: 10.1097/GME.0000000000001349.
We aimed to investigate whether the number of pregnancies during childbearing age was associated with diabetes in postmenopausal women with no history of gestational diabetes.
Our data source was the continuous National Health and Nutrition Examination Survey 1999 to 2014. We selected 9,138 postmenopausal women over 40 years old who did not have a history of gestational diabetes during pregnancy. Logistic regression analyses were applied for the association of the number of pregnancies with diabetes.
We found women with ≥4 pregnancies had significantly greater fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), 2-hour plasma glucose, and the Homeostatic Model Assessment of Insulin Resistance than those with two to three pregnancies (all P < 0.01). These women also had a significantly higher prevalence of diabetes (28.4% vs 20.7%; P < 0.001). Using the two to three pregnancies group as the reference, we observed a positive association of log-FPG and log-HbA1c with 4 or more pregnancies after adjustment for sociodemographic, lifestyle, and reproductive factors, and body mass index (both P < 0.05). Compared to women with two to three pregnancies, the odds ratios for diabetes were 1.31 (95% confidence interval [CI] 1.01-1.71) for women who never got pregnant and 1.28 (95% CI 1.10-1.48) for those with at least 4 pregnancies after multivariate adjustment.
At least 4 pregnancies through childbearing age may be a potential risk factor for diabetes in postmenopausal women without a history of gestational diabetes.
本研究旨在探讨生育期妊娠次数是否与无妊娠糖尿病病史的绝经后妇女的糖尿病相关。
我们的数据来源于 1999 年至 2014 年连续的全国健康和营养检查调查。我们选择了 9138 名年龄在 40 岁以上、怀孕期间无妊娠糖尿病史的绝经后妇女。应用 logistic 回归分析妊娠次数与糖尿病之间的关系。
我们发现，与有 2-3 次妊娠的妇女相比，有≥4 次妊娠的妇女空腹血糖（FPG）、糖化血红蛋白（HbA1c）、2 小时血糖和稳态模型评估的胰岛素抵抗指数显著升高（均 P<0.01）。这些妇女的糖尿病患病率也显著升高（28.4% vs 20.7%；P<0.001）。以 2-3 次妊娠组为参照，在校正社会人口统计学、生活方式和生殖因素以及体重指数后，我们发现 log-FPG 和 log-HbA1c 与 4 次或更多次妊娠呈正相关（均 P<0.05）。与有 2-3 次妊娠的妇女相比，从未怀孕的妇女患糖尿病的比值比为 1.31（95%置信区间[CI] 1.01-1.71），至少有 4 次妊娠的妇女为 1.28（95% CI 1.10-1.48），均为多因素调整后的结果。
生育期至少有 4 次妊娠可能是无妊娠糖尿病病史的绝经后妇女发生糖尿病的潜在危险因素。
