Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study
| Autor: | Maria G Araneta, Naji Younes, Marinella Temprosa, Catherine Kim, William C. Knowler, Ronald B. Goldberg, Xavier Pi-Sunyer, Angela L. Brown, Amisha Wallia, Christine Darwin, Sharon L. Edelstein, Uzoma N. Ibebuogu |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Infertility medicine.medical_specialty Diabetes risk Endocrinology Diabetes and Metabolism Clinical Biochemistry Gravidity 030209 endocrinology & metabolism Biochemistry 03 medical and health sciences 0302 clinical medicine Endocrinology Pregnancy Risk Factors Diabetes mellitus Internal medicine Preventive Health Services medicine Humans Life Style Aged 030219 obstetrics & reproductive medicine business.industry Proportional hazards model Obstetrics Incidence Biochemistry (medical) Hazard ratio Middle Aged medicine.disease Metformin United States Confidence interval Primary Prevention Online Only Treatment Outcome Diabetes Mellitus Type 2 Female business Infertility Female Risk Reduction Behavior Body mass index |
| Zdroj: | J Clin Endocrinol Metab |
| ISSN: | 1945-7197 0021-972X |
| DOI: | 10.1210/clinem/dgaa013 |
| Popis: | Objective The extent to which infertility and pregnancy independently increase risk of diabetes and subclinical atherosclerosis is not known. Research Design And Methods We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study over a 15-year period. We included women who answered questions about gravidity and infertility at baseline (n = 2085). Infertility was defined as > 1 year of unsuccessful attempts to conceive; thus, women could have histories of infertility as well as pregnancy. Risk of diabetes associated with gravidity and infertility was calculated using Cox proportional hazards models adjusting for age, race/ethnicity, treatment arm, body mass index, and pregnancy during the study. Among women who underwent assessment of coronary artery calcification (CAC) (n = 1337), odds of CAC were calculated using logistic regression models with similar covariates. Results Among premenopausal women (n = 1075), women with histories of pregnancy and infertility (n = 147; hazard ratio [HR] 1.80; 95% confidence interval [CI] 1.30, 2.49) and women with histories of pregnancy without infertility (n = 736; HR 1.49; 95% CI 1.15, 1.93) had greater diabetes risk than nulligravid women without infertility (n = 173). Premenopausal nulligravid women with histories of infertility had a non-significant elevation in risk, although the number of these women was small (n = 19; HR 1.63; 95% CI 0.88, 3.03). Associations were not observed among postmenopausal women (n = 1010). No associations were observed between infertility or pregnancy with CAC. Conclusions Pregnancy, particularly combined with a history of infertility, confers increased risk of diabetes but not CAC among glucose-intolerant premenopausal women. |
| Databáze: | OpenAIRE |
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