TY - JOUR
T1 - Parenthood and the risk of diabetes in men and women
T2 - a 7 year prospective study of 0.5 million individuals
AU - Peters, Sanne A.E.
AU - Yang, Ling
AU - Guo, Yu
AU - Chen, Yiping
AU - Bian, Zheng
AU - Millwood, Iona Y.
AU - Bragg, Fiona
AU - Zhou, Xue
AU - Ge, Pengfei
AU - Chen, Biyun
AU - Gao, Yulian
AU - Li, Yijun
AU - Chen, Junshi
AU - Li, Liming
AU - Woodward, Mark
AU - Chen, Zhengming
N1 - Funding Information:
We acknowledge the contribution of the participants, the project staff and the China National CDC and its regional offices for access to death and disease registries. The Chinese national health insurance scheme provides electronic linkage to all hospital admission data. A complete list of members of the China Kadoorie Biobank Collaboration Group is given in the electronic supplementary material (ESM) The CKB baseline survey was supported by the Kadoorie Charitable Foundation, Hong Kong. The long-term follow-up is supported by the UK Wellcome Trust (088158/Z/09/Z, 104085/Z/14/Z), Chinese Ministry of Science and Technology (2011BAI09B01, 201214), Chinese National Natural Science Foundation (81390541 and 81390544). The British Heart Foundation, UK Medical Research Council and Cancer Research UK provide core funding to the Oxford University Clinical Trial Service Unit and Epidemiological Studies Unit.
Funding Information:
The CKB baseline survey was supported by the Kadoorie Charitable Foundation, Hong Kong. The long-term follow-up is supported by the UK Wellcome Trust (088158/Z/09/Z, 104085/Z/14/Z), Chinese Ministry of Science and Technology (2011BAI09B01, 2012–14), Chinese National Natural Science Foundation (81390541 and 81390544). The British Heart Foundation, UK Medical Research Council and Cancer Research UK provide core funding to the Oxford University Clinical Trial Service Unit and Epidemiological Studies Unit.
Publisher Copyright:
© 2016, The Author(s).
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Aims/hypothesis: In women, higher parity has been associated with increased risk of diabetes later in life. It is unclear, however, whether this association is mainly due to biological effects of childbearing, or to socioeconomic and lifestyle factors associated with childrearing. We assessed the association between number of children and diabetes risk separately in women and men. Methods: Between 2004 and 2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30–79 (mean 51 years) from ten diverse regions across China. During 7 years of follow-up, 8,840 incident cases of diabetes were recorded among 463,347 participants without prior cardiovascular diseases or diabetes. Multivariable Cox regression yielded sex-specific HRs and 95% CIs for incident diabetes by number of children. Results: Overall, ∼98% of all participants had children. In women, there was a J-shaped association between number of children and risk of diabetes. Compared with women with one child, the adjusted HRs for diabetes were 1.39 (95% CI 1.11, 1.73) for childless women, 1.12 (95% CI 1.07, 1.18) for those with two children, 1.23 (95% CI 1.16, 1.31) for those with three children, and 1.32 (95% CI 1.21, 1.44) for those with four or more children. In men, there was a similar association with risk of diabetes; the corresponding HRs were 1.28 (95% CI 1.02, 1.60), 1.19 (95% CI 1.12, 1.26), 1.32 (95% CI 1.21, 1.44) and 1.41 (95% CI 1.24, 1.60), respectively. In both sexes, the findings were broadly similar in different population subgroups. Conclusions/interpretation: The similarity between women and men in the association between number of children and risk of diabetes suggests that parenthood is most likely to affect diabetes risk through factors associated with childrearing rather than via biological effects of childbearing.
AB - Aims/hypothesis: In women, higher parity has been associated with increased risk of diabetes later in life. It is unclear, however, whether this association is mainly due to biological effects of childbearing, or to socioeconomic and lifestyle factors associated with childrearing. We assessed the association between number of children and diabetes risk separately in women and men. Methods: Between 2004 and 2008, the nationwide China Kadoorie Biobank recruited 0.5 million individuals aged 30–79 (mean 51 years) from ten diverse regions across China. During 7 years of follow-up, 8,840 incident cases of diabetes were recorded among 463,347 participants without prior cardiovascular diseases or diabetes. Multivariable Cox regression yielded sex-specific HRs and 95% CIs for incident diabetes by number of children. Results: Overall, ∼98% of all participants had children. In women, there was a J-shaped association between number of children and risk of diabetes. Compared with women with one child, the adjusted HRs for diabetes were 1.39 (95% CI 1.11, 1.73) for childless women, 1.12 (95% CI 1.07, 1.18) for those with two children, 1.23 (95% CI 1.16, 1.31) for those with three children, and 1.32 (95% CI 1.21, 1.44) for those with four or more children. In men, there was a similar association with risk of diabetes; the corresponding HRs were 1.28 (95% CI 1.02, 1.60), 1.19 (95% CI 1.12, 1.26), 1.32 (95% CI 1.21, 1.44) and 1.41 (95% CI 1.24, 1.60), respectively. In both sexes, the findings were broadly similar in different population subgroups. Conclusions/interpretation: The similarity between women and men in the association between number of children and risk of diabetes suggests that parenthood is most likely to affect diabetes risk through factors associated with childrearing rather than via biological effects of childbearing.
KW - Children
KW - China
KW - Diabetes
KW - Men
KW - Parenthood
KW - Women
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U2 - 10.1007/s00125-016-3980-x
DO - 10.1007/s00125-016-3980-x
M3 - Article
C2 - 27193915
AN - SCOPUS:84969900590
SN - 0012-186X
VL - 59
SP - 1675
EP - 1682
JO - Diabetologia
JF - Diabetologia
IS - 8
ER -