Age at first childbirth and newly diagnosed diabetes among postmenopausal women: a cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

ABSTRACT CONTEXT AND OBJECTIVE: It has been reported that earlier age at first childbirth may increase the risk of adult-onset diabetes among postmenopausal women, a novel finding with important public health implications. To date, however, no known studies have attempted to replicate this finding. We aimed to test the hypothesis that age at first childbirth is associated with the risk of adult-onset diabetes among postmenopausal women. DESIGN AND SETTING: Cross-sectional analysis using baseline data from 2919 middle-aged and elderly postmenopausal women in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS: Age at first childbirth was determined from self-reporting and newly diagnosed diabetes through a 2-hour 75-g oral glucose tolerance test and/or glycated hemoglobin. Logistic regression was performed to examine associations between age at first childbirth and newly diagnosed diabetes among postmenopausal women. RESULTS: We did not find any association between age at first childbirth and diabetes, either when minimally adjusted for age, race and study center (odds ratio, OR [95% confidence interval, CI]: ≤ 19 years: 1.15 [0.82-1.59], 20-24 years: 0.90 [0.66-1.23] and ≥ 30 years: 0.86 [0.63-1.17] versus 25-29 years; P = 0.36) or when fully adjusted for childhood and adult factors (OR [95% CI]: ≤ 19 years: 0.95 [0.67-1.34], 20-24 years: 0.78 [0.56-1.07] and ≥ 30 years: 0.84 [0.61-1.16] versus 25-29 years; P = 0.40). CONCLUSION: Our current analysis does not support the existence of an association between age at first childbirth and adult-onset diabetes among postmenopausal women, which had been reported previously.

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Validation of the Swedish Diabetes Re-Grouping Scheme in Adult-Onset Diabetes in China

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa524 ◽

2020 ◽

Vol 105 (10) ◽

pp. e3519-e3528 ◽

Cited By ~ 2

Author(s):

Xia Li ◽

Shuting Yang ◽

Chuqing Cao ◽

Xiang Yan ◽

Lei Zheng ◽

...

Keyword(s):

Insulin Resistance ◽

Chinese Patients ◽

Diabetic Patients ◽

Model Assessment ◽

Adult Onset ◽

Newly Diagnosed ◽

Onset Diabetes ◽

Adult Onset Diabetes ◽

Diagnosed Diabetes ◽

Newly Diagnosed Diabetes

Abstract Context This study applied the Swedish novel data-driven classification in Chinese newly diagnosed diabetic patients and validated its adoptability. Objective This study aimed to validate the practicality of the Swedish diabetes regrouping scheme in Chinese adults with newly diagnosed diabetes. Design Patients were classified into 5 subgroups by K-means and Two-Step methods according to 6 clinical parameters. Setting Ambulatory care. Patients A cross-sectional survey of 15 772 patients with adult-onset newly diagnosed diabetes was conducted in China from April 2015 to October 2017. Intervention None. Main Outcome Measures Six parameters including glutamate decarboxylase antibodies (GADA), age of onset, body mass index (BMI), glycated hemoglobin A1c (HbA1c), homoeostatic model assessment 2 estimates of β-cell function (HOMA2-B) and insulin resistance (HOMA2-IR) were measured to calculate the patient subgroups. Results Our patients clustered into 5 subgroups: 6.2% were in the severe autoimmune diabetes (SAID) subgroup, 24.8% were in the severe insulin-deficient diabetes (SIDD) subgroup, 16.6% were in the severe insulin-resistance diabetes (SIRD) subgroup, 21.6% were in the mild obesity-related diabetes (MOD) subgroup and 30.9% were in the mild age-related diabetes (MARD) subgroup. When compared with the Swedish population, the proportion of SIDD subgroup was higher. In general, Chinese patients had younger age, lower BMI, higher HbA1c, lower HOMA2-B and HOMA2-IR, and higher insulin use but lower metformin usage than the Swedish patients. Conclusion The Swedish diabetes regrouping scheme is applicable to adult-onset diabetes in China, with a high proportion of patients with the severe insulin deficient diabetes. Further validations of long-term diabetes complications remain warranted in future studies.

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