Yanan Huo1, Lihong Cheng1, Chenxiu Wang1, Ying Deng1, Ruying Hu2, Lixin Shi3, Qin Wan4, Lulu Chen5, Tianshu Zeng5, Xuefeng Yu6, Xulei Tang7, Li Yan8, Guijun Qin9, Gang Chen10, Zhengnan Gao11, Guixia Wang12, Feixia Shen13, Zuojie Luo14, Yingfen Qin14, Li Chen15, Qiang Li16, Zhen Ye2, Yinfei Zhang17, Yufang Bi18,19, Jieli Lu18,19, Mian Li18,19, Min Xu18,19, Yu Xu18,19, Tiange Wang18,19, Zhiyun Zhao18,19, Yuhong Chen18,19, Hongyan Qi18,19, Yuanyue Zhu18,19, Chunyan Hu18,19, Qing Su20, Chao Liu21, Youmin Wang22, Shengli Wu23, Tao Yang24, Huacong Deng25, Jiajun Zhao26, Yiming Mu27, Guang Ning18,19, Weiqing Wang18,19, Anhua Lin1. 1. Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China. 2. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China. 3. Affiliated Hospital of Guiyang Medical College, Guiyang, China. 4. The Affiliated Hospital of Southwest Medical University, Luzhou, China. 5. Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 6. Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. 7. The First Hospital of Lanzhou University, Lanzhou, China. 8. Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China. 9. The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 10. Fujian Provincial Hospital, Fujian Medical University, Fuzhou, China. 11. Dalian Municipal Central Hospital, Dalian, China. 12. The First Hospital of Jilin University, Changchun, China. 13. The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. 14. The First Affiliated Hospital of Guangxi Medical University, Nanning, China. 15. Qilu Hospital of Shandong University, Jinan, China. 16. The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 17. Central Hospital of Shanghai Jiading District, Shanghai, China. 18. Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 19. Shanghai National Clinical Research Center for Endocrine and Metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai National Center for Translational Medicine, Ruijin Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China. 20. Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing, China. 21. The First Affiliated Hospital of Anhui Medical University, Hefei, China. 22. Karamay Municipal People's Hospital, Xinjiang, China. 23. The First Affiliated Hospital of Nanjing Medical University, Nanjing, China. 24. Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. 25. The First Affiliated Hospital of Chongqing Medical University, Chongqing, China. 26. Shandong Provincial Hospital affiliated to Shandong University, Jinan, China. 27. Chinese People's Liberation Army General Hospital, Beijing, China.
Abstract
BACKGROUND: Parity, pregnancy loss, and breastfeeding duration were found to be associated with diabetes. However, the results are inconsistent. Also, no epidemiological studies have examined the association of these reproductive factors with diabetes in the same large population. We aim to investigate the associations between parity, pregnancy loss, breastfeeding duration, and the risk of maternal diabetes in middle-aged and elderly Chinese females. METHODS: We included 131 174 females aged ≥40 years from the REACTION study (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study). Multivariable linear regression and logistic regression were used to assess the association between parity, pregnancy loss, and breastfeeding duration and type 2 diabetes. RESULTS: The number of parities and breastfeeding duration were positively related to fasting plasma glucose, 2-hour postload glucose, glycosylated hemoglobin, and homeostatic model assessment of insulin resistance. Compared with those with one birth, nulliparous women or women with 2 or ≥3 births had a significantly increased risk of diabetes. The odds ratios (OR) and 95% confidence intervals (CI) were 1.27 (1.10-1.48), 1.17 (1.12-1.22), and 1.28 (1.21-1.35), respectively. Compared with women without pregnancy loss, those who underwent 2 (OR 1.09; 95% CI, 1.04-1.14) or ≥3 pregnancy losses (OR 1.11; 95% CI, 1.04-1.18) had an increased risk of diabetes. Moreover, women with a breastfeeding duration ≥0 to 6 months (OR 0.82; 95% CI, 0.75-0.90) and ≥6 to 12 months (OR 0.94; 95% CI, 0.89-0.99) had a significantly lower risk of diabetes. CONCLUSIONS: Nulliparous women or women with multiparity or more than one pregnancy loss have an increased risk of diabetes in later life, while women who breastfeed more than 0 to 12 months have a lower risk of diabetes.
BACKGROUND: Parity, pregnancy loss, and breastfeeding duration were found to be associated with diabetes. However, the results are inconsistent. Also, no epidemiological studies have examined the association of these reproductive factors with diabetes in the same large population. We aim to investigate the associations between parity, pregnancy loss, breastfeeding duration, and the risk of maternal diabetes in middle-aged and elderly Chinese females. METHODS: We included 131 174 females aged ≥40 years from the REACTION study (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study). Multivariable linear regression and logistic regression were used to assess the association between parity, pregnancy loss, and breastfeeding duration and type 2 diabetes. RESULTS: The number of parities and breastfeeding duration were positively related to fasting plasma glucose, 2-hour postload glucose, glycosylated hemoglobin, and homeostatic model assessment of insulin resistance. Compared with those with one birth, nulliparous women or women with 2 or ≥3 births had a significantly increased risk of diabetes. The odds ratios (OR) and 95% confidence intervals (CI) were 1.27 (1.10-1.48), 1.17 (1.12-1.22), and 1.28 (1.21-1.35), respectively. Compared with women without pregnancy loss, those who underwent 2 (OR 1.09; 95% CI, 1.04-1.14) or ≥3 pregnancy losses (OR 1.11; 95% CI, 1.04-1.18) had an increased risk of diabetes. Moreover, women with a breastfeeding duration ≥0 to 6 months (OR 0.82; 95% CI, 0.75-0.90) and ≥6 to 12 months (OR 0.94; 95% CI, 0.89-0.99) had a significantly lower risk of diabetes. CONCLUSIONS: Nulliparous women or women with multiparity or more than one pregnancy loss have an increased risk of diabetes in later life, while women who breastfeed more than 0 to 12 months have a lower risk of diabetes.