Paige D Wartko1, Tiffany L Beck2,3, Susan D Reed2,3, Beth A Mueller2, Stephen E Hawes2. 1. Department of Epidemiology, University of Washington School of Public Health, 1959 NE Pacific Street, Health Sciences Building, F-262, Box 357660, Seattle, WA, 98195-7236, USA. pwartko@uw.edu. 2. Department of Epidemiology, University of Washington School of Public Health, 1959 NE Pacific Street, Health Sciences Building, F-262, Box 357660, Seattle, WA, 98195-7236, USA. 3. Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA.
Abstract
PURPOSE: Excess circulating insulin may contribute to endometrial cancer (EC) development; studies suggest increased risk of EC associated with type 2 diabetes. We investigated whether gestational diabetes is associated with increased risk of EC and its precursor, endometrial hyperplasia (EH). METHODS: We conducted a population-based, case-control study of women in Washington State. Cases were women with a hospital discharge record indicating the presence of EH/EC who could be linked to a prior delivery hospitalization or birth record from 1987 to 2013 (n = 593). Controls were randomly selected from remaining deliveries, frequency matched 10:1 on delivery year and maternal age at delivery (n = 5,743). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: After adjustment for race/ethnicity, maternal age at delivery, and delivery year, EH/EC was associated with a history of gestational diabetes (OR 1.73, 95% CI 1.27-2.35). This association was present for both EH and EC (OR 1.61, 95% CI 1.00-2.60 and OR 1.80, 95% CI 1.22-2.65, respectively). After adjustment for prepregnancy body mass index, the OR for EH/EC was attenuated and became statistically non-significant (OR 1.22, 95% CI 0.87-1.72), except in women <50 years old at the time of case ascertainment (OR 1.49, 95% CI 1.00-2.20). Associations were slightly stronger for EC than EH. CONCLUSIONS: We observed an association between EH/EC and a history of gestational diabetes specific to younger women. Future studies focusing on the relationships between gestational diabetes, obesity, and EC, including age at diagnosis, are warranted.
PURPOSE: Excess circulating insulin may contribute to endometrial cancer (EC) development; studies suggest increased risk of EC associated with type 2 diabetes. We investigated whether gestational diabetes is associated with increased risk of EC and its precursor, endometrial hyperplasia (EH). METHODS: We conducted a population-based, case-control study of women in Washington State. Cases were women with a hospital discharge record indicating the presence of EH/EC who could be linked to a prior delivery hospitalization or birth record from 1987 to 2013 (n = 593). Controls were randomly selected from remaining deliveries, frequency matched 10:1 on delivery year and maternal age at delivery (n = 5,743). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: After adjustment for race/ethnicity, maternal age at delivery, and delivery year, EH/EC was associated with a history of gestational diabetes (OR 1.73, 95% CI 1.27-2.35). This association was present for both EH and EC (OR 1.61, 95% CI 1.00-2.60 and OR 1.80, 95% CI 1.22-2.65, respectively). After adjustment for prepregnancy body mass index, the OR for EH/EC was attenuated and became statistically non-significant (OR 1.22, 95% CI 0.87-1.72), except in women <50 years old at the time of case ascertainment (OR 1.49, 95% CI 1.00-2.20). Associations were slightly stronger for EC than EH. CONCLUSIONS: We observed an association between EH/EC and a history of gestational diabetes specific to younger women. Future studies focusing on the relationships between gestational diabetes, obesity, and EC, including age at diagnosis, are warranted.
Entities:
Keywords:
Body mass index; Case–control study; Endometrial cancer; Endometrial hyperplasia; Gestational diabetes mellitus; Pregnancy
Authors: R Troisi; T Bjørge; M Gissler; T Grotmol; C M Kitahara; S M Myrtveit Saether; A G Ording; C Sköld; H T Sørensen; B Trabert; I Glimelius Journal: J Intern Med Date: 2018-03-25 Impact factor: 8.989
Authors: Delia Bogdanet; Catriona Reddin; Esther Macken; Tomas P Griffin; Narjes Fhelelboom; Linda Biesty; Shakila Thangaratinam; Eugene Dempsey; Caroline Crowther; Sander Galjaard; Michael Maresh; Mary R Loeken; Angela Napoli; Eleni Anastasiou; Eoin Noctor; Harold W de Valk; Mireille N M van Poppel; Andrea Agostini; Cheril Clarson; Aoife M Egan; Paula M O'Shea; Declan Devane; Fidelma P Dunne Journal: Diabetologia Date: 2019-07-04 Impact factor: 10.122