Leslie V Farland1, William J Degnan2, Holly R Harris3,4, Deirdre K Tobias5,6, Stacey A Missmer7,8. 1. Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. lfarland@email.arizona.edu. 2. Department of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA. 3. Epidemiology, Public Health Science Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. 4. Department of Epidemiology, University of Washington, Seattle, WA, USA. 5. Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 6. Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. 7. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 8. Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA.
Abstract
AIMS/HYPOTHESIS: The objective of this study was to investigate the association between laparoscopically confirmed endometriosis and risk of type 2 diabetes. METHODS: We used data from the Nurses' Health Study II, a prospective cohort of female nurses followed for >25 years (N = 112,037). We used Cox proportional hazards models to estimate the HRs and 95% CIs of incident, confirmed type 2 diabetes (n = 8496 participants) adjusted a priori for confounding factors. We additionally investigated differences in the relationship between endometriosis and type 2 diabetes by age (<50 or ≥50 years), BMI (<30 or ≥30 kg/m2), infertility history, menopausal status and history of gestational diabetes mellitus (GDM; restricted to parous women). RESULTS: We saw no association between laparoscopically confirmed endometriosis and risk of type 2 diabetes in multivariable confounder-adjusted models (HR 1.06 [95% CI 0.98, 1.13]) or models accounting for potential mediating factors (HR 0.94 [95% CI 0.87, 1.00]). However, we observed modest differences in the association between endometriosis and type 2 diabetes by BMI group, history of infertility and history of GDM. Among non-obese women (HR 1.17 [95% CI 1.02, 1.35]), women who never experienced infertility (HR 1.14 [95% CI 1.04, 1.25]) and women who never experienced GDM (HR 1.11 [95% CI 1.01, 1.22]), endometriosis was associated with greater risk of type 2 diabetes. CONCLUSIONS/ INTERPRETATION: Overall, women with endometriosis were not at increased risk of type 2 diabetes. However, among subgroups at low risk for type 2 diabetes (i.e. non-obese women and women with no prior history of infertility or GDM), endometriosis was associated with a modest increased risk of type 2 diabetes.
AIMS/HYPOTHESIS: The objective of this study was to investigate the association between laparoscopically confirmed endometriosis and risk of type 2 diabetes. METHODS: We used data from the Nurses' Health Study II, a prospective cohort of female nurses followed for >25 years (N = 112,037). We used Cox proportional hazards models to estimate the HRs and 95% CIs of incident, confirmed type 2 diabetes (n = 8496 participants) adjusted a priori for confounding factors. We additionally investigated differences in the relationship between endometriosis and type 2 diabetes by age (<50 or ≥50 years), BMI (<30 or ≥30 kg/m2), infertility history, menopausal status and history of gestational diabetes mellitus (GDM; restricted to parous women). RESULTS: We saw no association between laparoscopically confirmed endometriosis and risk of type 2 diabetes in multivariable confounder-adjusted models (HR 1.06 [95% CI 0.98, 1.13]) or models accounting for potential mediating factors (HR 0.94 [95% CI 0.87, 1.00]). However, we observed modest differences in the association between endometriosis and type 2 diabetes by BMI group, history of infertility and history of GDM. Among non-obese women (HR 1.17 [95% CI 1.02, 1.35]), women who never experienced infertility (HR 1.14 [95% CI 1.04, 1.25]) and women who never experienced GDM (HR 1.11 [95% CI 1.01, 1.22]), endometriosis was associated with greater risk of type 2 diabetes. CONCLUSIONS/ INTERPRETATION: Overall, women with endometriosis were not at increased risk of type 2 diabetes. However, among subgroups at low risk for type 2 diabetes (i.e. non-obese women and women with no prior history of infertility or GDM), endometriosis was associated with a modest increased risk of type 2 diabetes.
Authors: Anderson Sanches Melo; Julio César Rosa-e-Silva; Ana Carolina Japur de Sá Rosa-e-Silva; Omero Benedicto Poli-Neto; Rui Alberto Ferriani; Carolina Sales Vieira Journal: Fertil Steril Date: 2009-12-06 Impact factor: 7.329
Authors: Neil P Johnson; Lone Hummelshoj; G David Adamson; Jörg Keckstein; Hugh S Taylor; Mauricio S Abrao; Deborah Bush; Ludwig Kiesel; Rulla Tamimi; Kathy L Sharpe-Timms; Luk Rombauts; Linda C Giudice Journal: Hum Reprod Date: 2016-12-05 Impact factor: 6.918
Authors: J E Manson; E B Rimm; M J Stampfer; G A Colditz; W C Willett; A S Krolewski; B Rosner; C H Hennekens; F E Speizer Journal: Lancet Date: 1991-09-28 Impact factor: 79.321
Authors: Deirdre K Tobias; Audrey J Gaskins; Stacey A Missmer; Frank B Hu; JoAnn E Manson; Germaine M Buck Louis; Cuilin Zhang; Jorge E Chavarro Journal: Diabetologia Date: 2015-01-18 Impact factor: 10.122
Authors: Admir Agic; Hong Xu; Christopher Altgassen; Frank Noack; Monika M Wolfler; Klaus Diedrich; Michael Friedrich; Robert N Taylor; Daniela Hornung Journal: Reprod Sci Date: 2007-07 Impact factor: 3.060
Authors: Fan Mu; Holly R Harris; Janet W Rich-Edwards; Susan E Hankinson; Eric B Rimm; Donna Spiegelman; Stacey A Missmer Journal: Am J Epidemiol Date: 2018-03-01 Impact factor: 4.897
Authors: Girish Rayanagoudar; Amal A Hashi; Javier Zamora; Khalid S Khan; Graham A Hitman; Shakila Thangaratinam Journal: Diabetologia Date: 2016-04-13 Impact factor: 10.122
Authors: Leslie V Farland; William J Degnan; Melanie L Bell; Scott E Kasner; Ava L Liberman; Divya K Shah; Kathryn M Rexrode; Stacey A Missmer Journal: Stroke Date: 2022-07-21 Impact factor: 10.170
Authors: Leslie V Farland; Chia-Ling Liu; Hafsatou Diop; Howard J Cabral; Stacey A Missmer; Charles C Coddington; Sunah S Hwang; Judy E Stern Journal: Fertil Steril Date: 2022-01-17 Impact factor: 7.329