Gen Yuki, Kim Kyuho, Lee Joonyub, Jung Junyoung, Jung Sang-Hyuk, Won Hong-Hee, Kim Dokyoon, Jo Yun-Sung, Ahn Yu-Bae, Ko Seung-Hyun, Yun Jae-Seung
Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Diabetes Metab J. 2025 Jul;49(4):837-847. doi: 10.4093/dmj.2024.0536. Epub 2025 Feb 14.
Most studies focus solely on the relationship between parity and type 2 diabetes mellitus (T2DM) risk, providing limited insights into other contributing or protective factors. This study aims to explore the complex relationship between parity and T2DM risk, considering additional factors such as obesity, race, and body composition.
This prospective cohort study used data from 242,159 women aged 40 to 69 from the UK Biobank, none of whom had T2DM at baseline. Multivariable Cox proportional hazard models were applied to assess the association between parity and T2DM. Subgroup analyses were performed based on body mass index (BMI), waist circumference (WC), and race.
The hazard ratio for T2DM per additional child was 1.16 (95% confidence interval, 1.13 to 1.16). Subgroup analysis revealed that Asian women and those with obesity or abdominal obesity had a higher risk of T2DM associated with multiparity. No increased risk was observed in women with normal BMI or WC. Mediation analysis showed that WC and BMI significantly mediated the parity-T2DM relationship, accounting for 49% and 38% of the effect, respectively.
There is a clear positive association between multiparity and T2DM risk, particularly in Asian women and those with obesity. Maintaining normal BMI and WC appears to mitigate this risk, highlighting the importance of weight management for women at higher parity levels. These findings offer crucial insights for public health interventions aimed at reducing T2DM risk among women.
大多数研究仅关注生育次数与2型糖尿病（T2DM）风险之间的关系，对其他促成因素或保护因素的见解有限。本研究旨在探讨生育次数与T2DM风险之间的复杂关系，同时考虑肥胖、种族和身体成分等其他因素。
这项前瞻性队列研究使用了英国生物银行中242159名年龄在40至69岁之间的女性的数据，这些女性在基线时均无T2DM。应用多变量Cox比例风险模型评估生育次数与T2DM之间的关联。根据体重指数（BMI）、腰围（WC）和种族进行亚组分析。
每增加一个孩子患T2DM的风险比为1.16（95%置信区间，1.13至1.16）。亚组分析显示，亚洲女性以及肥胖或腹型肥胖的女性多胎生育与T2DM风险较高有关。BMI或WC正常的女性未观察到风险增加。中介分析表明，WC和BMI显著介导了生育次数与T2DM的关系，分别占效应的49%和38%。
多胎生育与T2DM风险之间存在明显的正相关，尤其是在亚洲女性和肥胖女性中。保持正常的BMI和WC似乎可以降低这种风险，突出了体重管理对高生育次数女性的重要性。这些发现为旨在降低女性T2DM风险的公共卫生干预提供了关键见解。
