Diabetes Care, Vol 16, Issue 12 1557-1564, Copyright © 1993 by American Diabetes Association
Reproductive history, glucose tolerance, and NIDDM in Hispanic and non-Hispanic white women. The San Luis Valley Diabetes Study
BW Alderman, JA Marshall, EJ Boyko, KA Markham, J Baxter and RF Hamman
Department of Epidemiology, University of Washington School of Public Health, Seattle 98195.
OBJECTIVE--To ascertain whether childbearing would decrease oral
glucose-stimulated insulin and C-peptide levels and increase the risk of
NIDDM and impaired glucose tolerance in a population of Hispanic and
non-Hispanic white women residing in the San Luis Valley of Colorado.
Several investigators have related childbearing to subsequent abnormal
glucose tolerance. RESEARCH DESIGN AND METHODS--In a population-based
case-control epidemiological study, diabetic patients 20-74 yr of age (n =
196) and randomly sampled control women subjects (n = 735) underwent a
glucose tolerance test, a physical examination, and an in-person
standardized interview. The relations between the live-birth number and
fasting and oral glucose stimulated glucose, insulin and C-peptide
concentrations, and NIDDM and impaired glucose tolerance were estimated
using linear or logistic regression to adjust for extraneous variables.
RESULTS--In women selected as control subjects, the live-birth number was
related to a significant decrease in the sum of 1- and 2-h C-peptide
concentrations (coefficient = -0.077, P < 0.001) and the logarithm of
the sum of 1- and 2-h insulin concentrations (coefficient = -0.014, P =
0.02). After adjustment for subscapular skin-fold thickness, the relative
odds of NIDDM for the live-birth number, which was small and of borderline
significance, diminished (odds ratio = 1.04 for one birth, P = 0.18).
Findings were similar for impaired glucose tolerance.
CONCLUSIONS--Childbearing was related to lower C-peptide and insulin levels
in Hispanic and non-Hispanic women of the San Luis Valley. It had little
apparent effect on later risk of NIDDM or impaired glucose tolerance.