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- Title
Multiparity Is Associated with Type 2 Diabetes Independent of Adiponectin and Visceral Adiposity.
- Authors
Araneta, Maria Rosario G.; Barrett-Connor, Elizabeth
- Abstract
Background: Multiparity has been associated with type 2 diabetes, primarily though postpartum weight retention, however, the association with adiponectin and visceral adipose tissue (VAT) has not been elucidated. We aimed to assess the association between multiparity and diabetes in a highly parous, non-obese population with elevated diabetes prevalence. Methods: Participants were postmenopausal women from the UCSD Filipino Women's Health Study without known cardiovascular disease who had at least one live birth. A 2 hour 75 gram OGTT was performed; fasting lipids and adiponectin, reproductive history, family history of diabetes, VAT by computed tomography, and lifestyle behaviors were measured between 1995-2002. Type 2 diabetes was defined by 1999 WHO criteria Results: Among 152 women, mean age was 59.5 years (range: 48-73), mean parity was 4.3 live births (range: 1-12 births). One-third had ≥ 5 births, and 25% had ≥ 6 births. Parity was classified into: low (1-2 births n=40), medium (35 births, n=76) and grand multiparity (6-12 births, n=36). Diabetes prevalence was 25% in the low birth group, 30.3% in the medium birth group and 50% among women with ≥ 6 births (p=0.048). Family history of diabetes, exercise, smoking and hypertension did not differ by parity. Compared to women in the low birth group, women with ≥ 6 births were older (62.4 vs 57.1 years, p=0.001), had lower college completion (22.2 vs 58%, p=0.006), larger age-adjusted BMI (25.9 vs 24.5 kg/m², p=0.039), waist girth (83.7 vs 77.9 cm, p=0.03), VAT (74.9 vs 58.4 cm³, p=0.02) and lower adiponectin concentration, (5.96 vs 7.23 mg/ul, p<0.0001, adjusted for age and VAT). Multivariate analysis showed that women with ≥ 6 births had a threefold higher odds of diabetes (Adjusted OR: 3.40, 95% CI: 1.13-10.2) compared to women with 1 to 2 births, after adjusting for adiponectin, VAT, family history of diabetes, age, education, hypertension and exercise. Adiponectin (AOR: 0.42, 95% CI: 0.20 - 0.89), family history of diabetes (AOR: 4.35, 95% CI: 1.9 - 9.7) and hypertension (AOR: 2.99, 95% CI: 1.3 - 7.1) were also independently associated with diabetes. No differences were observed in the odds of diabetes when comparing the grand multiparity group to those with 3 to 5 births (AOR: 1.10, 95% 0.41 - 2.91). Conclusions: Having ≥ 6 children was associated with diabetes, independent of adiponectin, VAT, and other known diabetes risk factors. High parity may exacerbate diabetes risk through lower adiponectin secretion or action, and myriad mechanisms that have yet to be identified.
- Publication
Diabetes, 2007, Vol 56, pA494
- ISSN
0012-1797
- Publication type
Academic Journal