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© 2002 by the American Diabetes Association, Inc.
Epidemiology/Health Services/Psychosocial Research |
Association of Parity With Risk of Type 2 Diabetes and Related Metabolic Disorders
1 Department of Public Health Sciences, University of Toronto, Toronto, Canada
2 Samuel Lunenfeld Research Institute, Mt. Sinai Hospital, Toronto, Canada
3 Centre for Studies in Family Medicine, University of Western Ontario, London, Canada
4 Robarts Research Institute, London, Canada
5 Department of Nutritional Sciences, University of Toronto, Toronto, Canada
6 Banting and Best Diabetes Centre, University of Toronto, Toronto, Canada
OBJECTIVE—The relationship between parity and risk of diabetes is controversial, and little information is available regarding associations between parity and measures of insulin resistance and ß-cell function. The objective of this study was to investigate the association between parity and risk of glucose intolerance and related metabolic disorders using data from a population-based study in a Native Canadian community.
RESEARCH DESIGN AND METHODS—Female participants (n = 383, aged 12–79 years) provided fasting blood samples for the determination of glucose, insulin, C-peptide, and proinsulin concentrations. A 75-g oral glucose tolerance test was administered, and diabetes and impaired glucose tolerance were diagnosed according to World Health Organization criteria. Waist circumference and percent body fat were determined. Information regarding occurrence of live births and previously diagnosed diabetes was obtained from interviewer-administered questionnaires.
RESULTS—Parity was associated with a significantly reduced risk of diabetes (nulliparous vs. 
1 birth, odds ratio 0.43, 95% CI 0.19– 0.94, P < 0.05) after adjustment for age and waist circumference. In addition, nondiabetic nulliparous women had significantly elevated concentrations of fasting insulin and proinsulin relative to nondiabetic parous women (all P < 0.05) in analyses adjusted for age and waist circumference.
CONCLUSIONS—Our results are consistent with those from other populations experiencing high rates of diabetes and suggest the presence of a diabetes-prone phenotype within the nulliparous subcohort of this population, which may contribute to infertility.
Abbreviations: CV, coefficient of variation • GDM, gestational diabetes mellitus • HOMAIR, homeostasis model assessment index of insulin resistance • IGT, impaired glucose tolerance • OC, oral contraceptive • OGTT, oral glucose tolerance test • OR, odds ratio • PCOS, polycystic ovary syndrome • SLHDP, Sandy Lake Health and Diabetes Project
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