TY - JOUR
T1 - Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study
AU - Kim, Catherine
AU - Younes, Naji
AU - Temprosa, Marinella
AU - Edelstein, Sharon
AU - Goldberg, Ronald B.
AU - Araneta, Maria G.
AU - Wallia, Amisha
AU - Brown, Angela
AU - Darwin, Christine
AU - Ibebuogu, Uzoma
AU - Pi-Sunyer, Xavier
AU - Knowler, William C.
N1 - Funding Information:
The Research Group gratefully acknowledges the commitment and dedication of the participants of the Diabetes Prevention Program (DPP). This study was supported by DK048489 from the NIDDK which provided funding to the clinical centers and the Coordinating Center for the design and conduct of the study, and collection, management, analysis, and interpretation of the data. The Southwestern American Indian Centers were supported directly by NIDDK, including its Intramural Research Program, and the Indian Health Service. The General Clinical Research Center Program, National Center for Research Resources, and the Department of Veterans Affairs supported data collection at many of the clinical centers. Funding was also provided by the National Institute of Child Health and Human Development, National Institute on Aging, National Eye Institute, National Heart Lung and Blood Institute, Office of Research on Women’s Health, National Institute on Minority Health and Health Disparities, Centers for Disease Control and Prevention, and American Diabetes Association. Bristol-Myers Squibb and Parke-Davis provided additional funding and material support during DPP, Lipha (Merck-Sante) provided medication, and LifeScan Inc. donated materials during DPP and DPPOS. The opinions expressed herein are those of the investigators and do not necessarily reflect the views of the funding agencies. A complete list of Centers, investigators, and staff can be found at https://dppos. bsc.gwu.edu/web/dppos/appendix. The Research Group gratefully acknowledges the commitment and dedication of the participants of the DPP and DPPOS.
Publisher Copyright:
© 2020 Endocrine Society 2020.
PY - 2020/1/8
Y1 - 2020/1/8
N2 - 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.
AB - 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.
KW - coronary artery calcification
KW - diabetes
KW - infertility
KW - pregnancy
UR - http://www.scopus.com/inward/record.url?scp=85079086776&partnerID=8YFLogxK
U2 - 10.1210/clinem/dgaa013
DO - 10.1210/clinem/dgaa013
M3 - Article
C2 - 31955207
AN - SCOPUS:85079086776
SN - 0021-972X
VL - 105
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 3
M1 - dgaa013
ER -