Alderman B W, Marshall J A, Boyko E J, Markham K A, Baxter J, Hamman R F
Department of Epidemiology, University of Washington School of Public Health, Seattle 98195.
Diabetes Care. 1993 Dec;16(12):1557-64. doi: 10.2337/diacare.16.12.1557.
To ascertain whether childbearing would decrease oral glucose-stimulated insulin and C-peptide levels and increase the risk of NIDDM and impaired glucose tolerance in a population of Hispanic and non-Hispanic white women residing in the San Luis Valley of Colorado. Several investigators have related childbearing to subsequent abnormal glucose tolerance.
In a population-based case-control epidemiological study, diabetic patients 20-74 yr of age (n = 196) and randomly sampled control women subjects (n = 735) underwent a glucose tolerance test, a physical examination, and an in-person standardized interview. The relations between the live-birth number and fasting and oral glucose stimulated glucose, insulin and C-peptide concentrations, and NIDDM and impaired glucose tolerance were estimated using linear or logistic regression to adjust for extraneous variables.
In women selected as control subjects, the live-birth number was related to a significant decrease in the sum of 1- and 2-h C-peptide concentrations (coefficient = -0.077, P < 0.001) and the logarithm of the sum of 1- and 2-h insulin concentrations (coefficient = -0.014, P = 0.02). After adjustment for subscapular skin-fold thickness, the relative odds of NIDDM for the live-birth number, which was small and of borderline significance, diminished (odds ratio = 1.04 for one birth, P = 0.18). Findings were similar for impaired glucose tolerance.
Childbearing was related to lower C-peptide and insulin levels in Hispanic and non-Hispanic women of the San Luis Valley. It had little apparent effect on later risk of NIDDM or impaired glucose tolerance.
确定在居住于科罗拉多州圣路易斯河谷的西班牙裔和非西班牙裔白人女性群体中,生育是否会降低口服葡萄糖刺激后的胰岛素和C肽水平,并增加非胰岛素依赖型糖尿病(NIDDM)及糖耐量受损的风险。几位研究者已将生育与随后出现的糖耐量异常联系起来。
在一项基于人群的病例对照流行病学研究中,20 - 74岁的糖尿病患者(n = 196)和随机抽取的对照女性受试者(n = 735)接受了葡萄糖耐量试验、体格检查以及面对面的标准化访谈。使用线性或逻辑回归来调整外部变量,以评估活产数与空腹及口服葡萄糖刺激后的血糖、胰岛素和C肽浓度,以及NIDDM和糖耐量受损之间的关系。
在被选为对照受试者的女性中,活产数与1小时和2小时C肽浓度之和的显著降低相关(系数 = -0.077,P < 0.001),以及与1小时和2小时胰岛素浓度之和的对数相关(系数 = -0.014,P = 0.02)。在调整肩胛下皮肤褶厚度后,活产数与NIDDM的相对比值较小且具有临界显著性,该比值降低(一次生育的比值比 = 1.04,P = 0.18)。糖耐量受损的情况也类似。
在圣路易斯河谷的西班牙裔和非西班牙裔女性中,生育与较低的C肽和胰岛素水平相关。它对后期NIDDM风险或糖耐量受损几乎没有明显影响。