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Published online May 5, 2008
Diabetes Care 31:1635-1638, 2008
DOI: 10.2337/dc08-0621
© 2008 by the American Diabetes Association
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Cardiovascular and Metabolic Risk
Original Research

Dysglycemia and a History of Reproductive Risk Factors

Sarah D. McDonald, MD, MSC1, Salim Yusuf, MD, DPHIL2,3,4, Patrick Sheridan, MSC4, Sonia S. Anand, MD, PHD2,4, Hertzel C. Gerstein, MD, MSC2,4,5 for the DREAM Trial Investigators

1 Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
2 Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
3 Division of Cardiology, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
4 Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
5 Division of Endocrinology and Metabolism, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada

Corresponding author: Sarah D. McDonald, mcdonals{at}mcmaster.ca

OBJECTIVE—The purpose of this study was to identify reproductive risk factors associated with dysglycemia (diabetes, impaired glucose tolerance, and impaired fasting glucose) in a contemporary multiethnic population.

RESEARCH DESIGN AND METHODS—We studied 14,661 women screened with an oral glucose tolerance test for the Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) trial. Reproductive risk factors were compared in normoglycemic and dysglycemic women.

RESULTS—Dysglycemia was significantly associated with the number of children born (odds ratio 1.03 per child [95% CI 1.01–1.05]), age (1.05 per year [1.04–1.05]), non-European ancestry (1.09 [1.01–1.17]), preeclampsia/eclampsia (1.14 [1.02–1.27]), irregular periods (1.21 [1.07–1.36]), and gestational diabetes mellitus (GDM) (1.53 [1.35–1.74]). The relationship between GDM and dysglycemia did not differ across BMI tertiles (P = 0.84) nor did the relationships of other risk factors.

CONCLUSIONS—Reproductive factors, particularly GDM, are associated with dysglycemia in middle-aged women from many ethnicities. Reproductive factors can be used to counsel young women about their future risk of dysglycemia, whereas in middle age they may help screen for dysglycemia.


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