School of Public Health, Sun Yat-Sen University, 74 Zhongshan 2nd Road, Guangzhou, 510080, Guangdong, China.
Molecular Epidemiology Research Centre, Guangzhou Twelfth People's Hospital, Guangzhou, 510620, China.
Sci Rep. 2023 Jun 12;13(1):9504. doi: 10.1038/s41598-023-36786-x.
This study examined the association between parity and incident type 2 diabetes in older Chinese women and estimated the mediation effect of adiposity indicators. A total of 11,473 women without diabetes at baseline from 2003 to 2008 were followed up until 2012. We used Cox proportional hazards regression to assess the association between parity and incident type 2 diabetes, and mediation analysis to estimate the mediation effect of adiposity indicators. Compared to women with one parity, the hazard ratio (HR) (95% confidence interval (CI)) for incident type 2 diabetes was 0.85 (0.44-1.63), 1.20 (1.11-1.30), 1.28 (1.16-1.41) and 1.27 (1.14-1.42) for women with parity of 0, 2, 3, and ≥ 4, respectively. The proportion of indirect effect (95% CI) mediated by body mass index, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio and body fat percentage was 26.5% (19.2-52.2%), 54.5% (39.4-108.7%), 25.1% (18.2-49.1%), 35.9% (25.6-74.1%), 50.3% (36.5-98.6%) and 15.1% (- 66.4 to 112.3%), respectively. Compared to women with one parity, women with multiparity (≥ 2) had a higher risk of incident type 2 diabetes and up to half of the association was mediated by abdominal obesity.
本研究旨在探讨中国老年女性生育次数与 2 型糖尿病发病风险的关系,并估计肥胖指标的中介效应。共有 11473 名 2003 年至 2008 年基线时无糖尿病的女性接受了随访,随访至 2012 年。我们采用 Cox 比例风险回归评估生育次数与 2 型糖尿病发病风险的关系,并采用中介分析估计肥胖指标的中介效应。与生育一次的女性相比,生育次数为 0、2、3 和≥4 的女性发生 2 型糖尿病的风险比(HR)(95%置信区间(CI))分别为 0.85(0.44-1.63)、1.20(1.11-1.30)、1.28(1.16-1.41)和 1.27(1.14-1.42)。体质指数、腰围、臀围、腰臀比、腰围身高比和体脂百分比介导的间接效应比例(95%CI)分别为 26.5%(19.2-52.2%)、54.5%(39.4-108.7%)、25.1%(18.2-49.1%)、35.9%(25.6-74.1%)、50.3%(36.5-98.6%)和 15.1%(-66.4-112.3%)。与生育一次的女性相比,生育次数≥2 的女性发生 2 型糖尿病的风险更高,其中一半以上的关联可归因于腹型肥胖。