Nirmala Pandeya1,2, Rachel R Huxley3, Hsin-Fang Chung1, Annette J Dobson1, Diana Kuh4, Rebecca Hardy4, Janet E Cade5, Darren C Greenwood5, Graham G Giles6,7, Fiona Bruinsma6, Panayotes Demakakos8, Mette Kildevaeld Simonsen9, Hans-Olov Adami10,11, Elisabete Weiderpass10,12,13,14, Gita D Mishra1. 1. School of Public Health, University of Queensland, Brisbane, Queensland, Australia. 2. QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. 3. La Trobe University, Melbourne, Victoria, Australia. 4. Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK. 5. Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK. 6. Cancer Epidemiology and Intelligence Division Centre, Cancer Council Victoria, Melbourne, Victoria, Australia. 7. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. 8. Department of Epidemiology and Public Health, University College London, London, UK. 9. UcDiakonissen and Parker Institute, Frederiksberg, Denmark. 10. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. 11. Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway. 12. Genetic Epidemiology Group, Folkhälsan Research Centre and Faculty of Medicine, University of Helsinki, Helsinki, Finland. 13. Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway. 14. Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Norway.
Abstract
AIM: To examine the prospective associations between aspects of a woman's reproductive history and incident diabetes. METHODS: We pooled individual data from 126 721 middle-aged women from eight cohort studies contributing to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE). Associations between age at menarche, age at first birth, parity and menopausal status with incident diabetes were examined using generalized linear mixed models, with binomial distribution and robust variance. We stratified by body mass index (BMI) when there was evidence of a statistical interaction with BMI. RESULTS: Over a median follow-up of 9 years, 4073 cases of diabetes were reported. Non-linear associations with diabetes were observed for age at menarche, parity and age at first birth. Compared with menarche at age 13 years, menarche at ≤10 years was associated with an 18% increased risk of diabetes (relative risk [RR] 1.18, 95% confidence interval [CI] 1.02-1.37) after adjusting for BMI. After stratifying by BMI, the increased risk was only observed in women with a BMI ≥25 kg/m2 . A U-shaped relationship was observed between parity and risk of diabetes. Compared with pre-/peri-menopausal women, women with a hysterectomy/oophorectomy had an increased risk of diabetes (RR 1.17, 95% CI 1.07-1.29). CONCLUSIONS: Several markers of a woman's reproductive history appear to be modestly associated with future risk of diabetes. Maintaining a normal weight in adult life may ameliorate any increase in risk conferred by early onset of menarche.
AIM: To examine the prospective associations between aspects of a woman's reproductive history and incident diabetes. METHODS: We pooled individual data from 126 721 middle-aged women from eight cohort studies contributing to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE). Associations between age at menarche, age at first birth, parity and menopausal status with incident diabetes were examined using generalized linear mixed models, with binomial distribution and robust variance. We stratified by body mass index (BMI) when there was evidence of a statistical interaction with BMI. RESULTS: Over a median follow-up of 9 years, 4073 cases of diabetes were reported. Non-linear associations with diabetes were observed for age at menarche, parity and age at first birth. Compared with menarche at age 13 years, menarche at ≤10 years was associated with an 18% increased risk of diabetes (relative risk [RR] 1.18, 95% confidence interval [CI] 1.02-1.37) after adjusting for BMI. After stratifying by BMI, the increased risk was only observed in women with a BMI ≥25 kg/m2 . A U-shaped relationship was observed between parity and risk of diabetes. Compared with pre-/peri-menopausal women, women with a hysterectomy/oophorectomy had an increased risk of diabetes (RR 1.17, 95% CI 1.07-1.29). CONCLUSIONS: Several markers of a woman's reproductive history appear to be modestly associated with future risk of diabetes. Maintaining a normal weight in adult life may ameliorate any increase in risk conferred by early onset of menarche.
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Authors: H-F Chung; D Zhu; A J Dobson; D Kuh; E B Gold; S L Crawford; N E Avis; E S Mitchell; N F Woods; D J Anderson; G D Mishra Journal: BJOG Date: 2020-07-21 Impact factor: 6.531