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日本产次与2型糖尿病的关联

Association of Parity with Type 2 Diabetes Mellitus in Japan.

作者信息

Wang Hongxin, Iwama Noriyuki, Yuwaki Keiichi, Nakamichi You, Hamada Hirotaka, Tomita Hasumi, Tagami Kazuma, Kudo Rie, Kumagai Natsumi, Metoki Hirohito, Nakaya Naoki, Hozawa Atsushi, Kuriyama Shinichi, Yaegashi Nobuo, Saito Masatoshi

机构信息

Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Tohoku University Hospital, 1-1, Seiryomachi, Sendai, Miyagi, Japan.

Women's Health Care Medical Science, Tohoku University Graduate School of Medicine, 1-1, Seiryomachi, Sendai, Miyagi, Japan.

出版信息

Reprod Sci. 2025 Feb;32(2):366-381. doi: 10.1007/s43032-024-01752-z. Epub 2024 Dec 11.

Abstract

This study investigates the association between parity and type 2 diabetes mellitus (T2DM) in Japanese women, considering the clinical history of gestational diabetes mellitus (GDM) and menopausal status, which are known risk factors for T2DM. Overall, 30,116 Japanese women (6,588 premenopausal and 23,528 postmenopausal) were included in this cross-sectional study. They were divided into two groups according to menopausal status (premenopausal and postmenopausal women), and the association between parity and T2DM was evaluated using a multiple logistic regression model with possible confounders, including a clinical history of GDM. The association between parity and T2DM was not statistically significant in premenopausal women. In contrast, a linear graded association between parity and T2DM was found in postmenopausal women. Furthermore, the association between parity and T2DM in postmenopausal women was attenuated after adjusting for body weight gain after the age of 20 years. A clinical history of GDM was significantly associated with a high risk for T2DM, regardless of adjustment for body weight gain after the age of 20 years in both premenopausal and postmenopausal women. Parity is associated with an increased risk of T2DM in postmenopausal women but not in premenopausal women. Maintaining appropriate body weight would be beneficial in attenuating the risk of T2DM in postmenopausal women. A clinical history of GDM is a risk factor for T2DM in both pre- and postmenopausal women; therefore, women with a clinical history of GDM require continuous medical care to survey for T2DM.

摘要

本研究调查了日本女性的生育次数与2型糖尿病(T2DM)之间的关联,并考虑了妊娠糖尿病(GDM)的临床病史和绝经状态,这些都是已知的T2DM风险因素。总体而言,这项横断面研究纳入了30116名日本女性(6588名绝经前女性和23528名绝经后女性)。她们根据绝经状态分为两组(绝经前和绝经后女性),并使用多因素逻辑回归模型评估生育次数与T2DM之间的关联,模型中纳入了包括GDM临床病史在内的可能混杂因素。生育次数与T2DM之间的关联在绝经前女性中无统计学意义。相比之下,在绝经后女性中发现生育次数与T2DM之间存在线性分级关联。此外,在调整20岁后体重增加情况后,绝经后女性中生育次数与T2DM之间的关联减弱。无论是否调整20岁后体重增加情况,GDM临床病史在绝经前和绝经后女性中均与T2DM的高风险显著相关。生育次数与绝经后女性而非绝经前女性的T2DM风险增加相关。保持适当体重将有助于降低绝经后女性患T2DM的风险。GDM临床病史是绝经前和绝经后女性患T2DM的风险因素;因此,有GDM临床病史的女性需要持续医疗护理以监测T2DM。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f86/11825537/ad8c2d74d7ae/43032_2024_1752_Fig1_HTML.jpg

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