Grand Multiparity Is Associated With Type 2 Diabetes in Filipino American Women, Independent of Visceral Fat and Adiponectin

Abstract

OBJECTIVE To determine whether multiparity is associated with type 2 diabetes, independent of visceral adipose tissue (VAT) and adipokines. RESEARCH DESIGN AND METHODS Participants were from the University of California San Diego Filipino Women's Health Study with at least one live birth. A 2-h 75-g oral glucose tolerance test was administered; adiponectin, leptin, ghrelin, reproductive history, family history of diabetes, VAT, and lifestyle behaviors were measured between 1995 and 2002. RESULTS Among 152 women, mean age was 59.5 years (range 48–73 years) and mean parity was 4.3 (range 1–12 births). Type 2 diabetes prevalence increased by parity group (low parity, 1–2 births, 25%; medium parity, 3–5 births, 30.3%; and grand multiparity: 6–12 births, 50%; P = 0.048). Family history of diabetes, exercise, insulin resistance, and leptin and ghrelin levels did not differ by parity group. Compared with women in the low parity group, women with ≥6 births were significantly older (62 vs. 57 years), had lower college completion (22 vs. 58%, P = 0.006), more hypertension (72 vs. 55%), higher VAT (74.9 vs. 58.4 cm3), and lower adiponectin concentration (5.79 vs. 7.61 μg/ml). In multivariate analysis adjusting for adiponectin, VAT, family history of diabetes, age, education, hypertension, and estrogen use, grand multiparous women had a threefold higher odds of type 2 diabetes (adjusted odds ratio 3.40 [95% CI 1.13–10.2]) compared with low parity women. No differences were observed in the odds of diabetes between women in the medium (1.10 [0.41–2.91]) and low parity groups. CONCLUSIONS Having ≥6 children was associated with type 2 diabetes, independent of adiponectin, VAT, family history, and other measured diabetes risk factors.