Korean J Fam Pract. 2018; 8(1): 59-65  https://doi.org/10.21215/kjfp.2018.8.1.59
The Association between Parity, Lactation, and Impaired Fasting Glucose in Korean Women: The 5th Korean National Health and Nutrition Examination Survey, 2010-2012
Nam Hee Yoon, Ji Ho Choi*, Yeon Ji Lee, Jeong Min Oh, Yu Rim Lee, Hyeun Jin Song
Department of Family Medicine, Inha University College of Medicine, Incheon, Korea
Ji Ho Choi
Tel: +82-32-890-2240, Fax: +82-32-890-2195
E-mail: wisdom@inha.ac.kr
ORCID: http://orcid.org/0000-0002-9054-7805
Received: March 10, 2017; Revised: August 30, 2017; Accepted: September 7, 2017; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The purpose of this study was to analyze the association between the risk of impaired fasting glucose (IFG) and parity, and the effect of lactation on fasting blood glucose.
Methods: We finally included 7,090 women who participated in Korean National Health and Nutrition Examination Survey between 2010 and 2012. We categorized into four groups according to parity and estimated the risk of impaired fasting glucose according to parity and duration of lactation, by using logistic regression analysis.
Results: The fasting plasma glucose levels and the prevalence of impaired fasting glucose increased according to increasing number of live births (P＜0.001). Comparing with nulliparous women, parous women had a higher risk of IFG. The multivariate-adjusted odd ratio (aOR) for IFG for the birth numbers 1, 2, 3, and 4 were 1.339 (95% confidence interval [CI], 0.840−2.134), 1.558 (95% CI, 1.041−2.333), 1.513 (95% CI, 0.935−2.451), and 1.320 (95% CI, 0.801−2.177). Among parous women, increasing duration of lactation was associated with a reduced risk of IFG, significantly. The multivariate aOR of IFG for total duration of lactation and average duration per child of lactation were 0.996 (95% CI, 0.992−0.999) and 0.986 (95% CI, 0.976−0.997).
Conclusion: We found that multiparity may be associated with increasing risk of impaired fasting glucose, and conversely, lactation may reduce this risk among Korean women.
Keywords: Parity; Fasting Plasma Glucose; Impaired Fasting Glucose; Lactation
References
  1. Korea Diabetes Association, Korea Centers for Disease Control and Prevention. Diabetes Fact sheet in Korea 2016. Seoul: Korean Diabetes Association;2015.
  2. Nathan DM, Davidson MB, DeFronzo RA, Heine RJ, Henry RR, Pratley R, et al. Impaired fasting glucose and impaired glucose tolerance: implications for care. Diabetes Care 2007; 30: 753-9.
    Pubmed CrossRef
  3. Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. Prediabetes: a high-risk state for diabetes development. Lancet 2012; 379: 2279-90.
    CrossRef
  4. Levitan EB, Song Y, Ford ES, Liu S. Is nondiabetic hyperglycemia a risk factor for cardiovascular disease? A meta-analysis of prospective studies. Arch Intern Med 2004; 164: 2147-55.
    Pubmed CrossRef
  5. Balkau B, Hu G, Qiao Q, Tuomilehto J, Borch-Johnsen K, Pyörälä K. Prediction of the risk of cardiovascular mortality using a score that includes glucose as a risk factor. The DECODE Study. Diabetologia 2004; 47: 2118-28.
    Pubmed CrossRef
  6. McIntyre HD, Chang AM, Callaway LK, Cowley DM, Dyer AR, Radaelli T, et al. Hormonal and metabolic factors associated with variations in insulin sensitivity in human pregnancy. Diabetes Care 2010; 33: 356-60.
    Pubmed KoreaMed CrossRef
  7. Newbern D, Freemark M. Placental hormones and the control of maternal metabolism and fetal growth. Curr Opin Endocrinol Diabetes Obes 2011;18: 409-16.
    Pubmed CrossRef
  8. Pereira MA, Rifas-Shiman SL, Kleinman KP, Rich-Edwards JW, Peterson KE, Gillman MW. Predictors of change in physical activity during and after pregnancy: Project Viva. Am J Prev Med 2007; 32: 312-9.
    Pubmed KoreaMed CrossRef
  9. Li P, Shan Z, Zhou L, Xie M, Bao W, Zhang Y, et al. Mechanisms in endocrinology:Parity and risk of type 2 diabetes: a systematic review and dose-response meta-analysis. Eur J Endocrinol 2016; 175: R231-45.
    Pubmed CrossRef
  10. Gunderson EP. Childbearing and obesity in women: weight before, during, and after pregnancy. Obstet Gynecol Clin North Am 2009; 36: 317-32.
    Pubmed KoreaMed CrossRef
  11. Gunderson EP, Jacobs DR Jr, Chiang V, Lewis CE, Feng J, Quesenberry CP Jr, et al. Duration of lactation and incidence of the metabolic syndrome in women of reproductive age according to gestational diabetes mellitus status:a 20-Year prospective study in CARDIA (Coronary Artery Risk Development in Young Adults). Diabetes 2010; 59: 495-504.
    Pubmed KoreaMed CrossRef
  12. Gunderson EP, Matias SL, Hurston SR, Dewey KG, Ferrara A, Quesenberry CP Jr, et al. Study of women, infant feeding, and type 2 diabetes mellitus after GDM pregnancy (SWIFT), a prospective cohort study: methodology and design. BMC Public Health 2011; 11: 952.
    Pubmed KoreaMed CrossRef
  13. Gunderson EP, Lewis CE, Tsai AL, Chiang V, Carnethon M, Quesenberry CP Jr, et al. A 20-year prospective study of childbearing and incidence of diabetes in young women, controlling for glycemia before conception: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Diabetes 2007; 56: 2990-6.
    Pubmed KoreaMed CrossRef
  14. Liu B, Jorm L, Banks E. Parity, breastfeeding, and the subsequent risk of maternal type 2 diabetes. Diabetes Care 2010; 33: 1239-41.
    Pubmed KoreaMed CrossRef
  15. Sichieri R, Field AE, Rich-Edwards J, Willett WC. Prospective assessment of exclusive breastfeeding in relation to weight change in women. Int J Obes Relat Metab Disord 2003; 27: 815-20.
    Pubmed CrossRef
  16. Linné Y, Barkeling B, Rössner S. Long-term weight development after pregnancy. Obes Rev 2002; 3: 75-83.
    Pubmed CrossRef
  17. Stuebe AM, Rich-Edwards JW, Willett WC, Manson JE, Michels KB. Duration of lactation and incidence of type 2 diabetes. JAMA 2005; 294: 260110.
    Pubmed CrossRef
  18. Fewtrell MS, Morgan JB, Duggan C, Gunnlaugsson G, Hibberd PL, Lucas A, et al. Optimal duration of exclusive breastfeeding: what is the evidence to support current recommendations? Am J Clin Nutr 2007; 85: 635S-8S.
    Pubmed CrossRef
  19. Dahlgren J. Pregnancy and insulin resistance. Metab Syndr Relat Disord 2006; 4: 149-52.
    Pubmed CrossRef
  20. Gunderson EP, Murtaugh MA, Lewis CE, Quesenberry CP, West DS, Sidney S. Excess gains in weight and waist circumference associated with childbearing:The Coronary Artery Risk Development in Young Adults Study (CARDIA). Int J Obes Relat Metab Disord 2004; 28: 525-35.
    Pubmed KoreaMed CrossRef
  21. Rieck S, Kaestner KH. Expansion of beta-cell mass in response to pregnancy. Trends Endocrinol Metab 2010; 21: 151-8.
    Pubmed KoreaMed CrossRef
  22. Mamun AA, Kinarivala M, O’Callaghan MJ, Williams GM, Najman JM, Callaway LK. Associations of excess weight gain during pregnancy with long-term maternal overweight and obesity: evidence from 21 y postpartum follow-up. Am J Clin Nutr 2010; 91: 1336-41.
    Pubmed CrossRef
  23. Al Mamun A, Mannan M, O’Callaghan MJ, Williams GM, Najman JM, Callaway LK. Association between gestational weight gain and postpartum diabetes:evidence from a community based large cohort study. PLoS One 2013; 8: e75679.
    Pubmed KoreaMed CrossRef

This Article


Author ORCID Information

Services
Social Network Service

e-submission

Archives