Infertility, gravidity, and risk of diabetes among high-risk women in the Diabetes Prevention Program Outcomes Study.

Infertility, gravidity, and risk of diabetes among high-risk women in the Diabetes Prevention Program Outcomes Study.:

Related Articles

Infertility, gravidity, and risk of diabetes among high-risk women in the Diabetes Prevention Program Outcomes Study.

J Clin Endocrinol Metab. 2020 Jan 19;:

Authors: Kim C, Younes N, Temprosa M, Edelstein S, Goldberg RB, Araneta MG, Wallia A, Brown A, Darwin C, Ibebuogu U, Pi-Sunyer X, Knowler WC, Diabetes Prevention Program Research Group

Abstract

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.

PMID: 31955207 [PubMed - as supplied by publisher]