Volume 20, Issue 9 p. 2103-2112
ORIGINAL ARTICLE

Female reproductive history and risk of type 2 diabetes: A prospective analysis of 126 721 women

Nirmala Pandeya PhD

Nirmala Pandeya PhD

School of Public Health, University of Queensland, Brisbane, Queensland, Australia

QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia

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Rachel R. Huxley DPhil

Corresponding Author

Rachel R. Huxley DPhil

La Trobe University, Melbourne, Victoria, Australia

Correspondence

Rachel Huxley DPhil, College of Science, Health and Engineering, La Trobe University, Bundoora, Australia.

Email: r.huxley@latrobe.edu.au

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Hsin-Fang Chung PhD

Hsin-Fang Chung PhD

School of Public Health, University of Queensland, Brisbane, Queensland, Australia

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Annette J. Dobson PhD

Annette J. Dobson PhD

School of Public Health, University of Queensland, Brisbane, Queensland, Australia

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Diana Kuh PhD

Diana Kuh PhD

Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK

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Rebecca Hardy PhD

Rebecca Hardy PhD

Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, UK

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Janet E. Cade PhD

Janet E. Cade PhD

Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK

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Darren C. Greenwood PhD

Darren C. Greenwood PhD

Nutritional Epidemiology Group, School of Food Science and Nutrition, University of Leeds, Leeds, UK

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Graham G. Giles PhD

Graham G. Giles PhD

Cancer Epidemiology and Intelligence Division Centre, Cancer Council Victoria, Melbourne, Victoria, Australia

Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia

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Fiona Bruinsma PhD

Fiona Bruinsma PhD

Cancer Epidemiology and Intelligence Division Centre, Cancer Council Victoria, Melbourne, Victoria, Australia

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Panayotes Demakakos PhD

Panayotes Demakakos PhD

Department of Epidemiology and Public Health, University College London, London, UK

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Mette Kildevæld Simonsen PhD

Mette Kildevæld Simonsen PhD

UcDiakonissen and Parker Institute, Frederiksberg, Denmark

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Hans-Olov Adami PhD

Hans-Olov Adami PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway

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Elisabete Weiderpass PhD

Elisabete Weiderpass PhD

Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden

Genetic Epidemiology Group, Folkhälsan Research Centre and Faculty of Medicine, University of Helsinki, Helsinki, Finland

Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway

Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Norway

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Gita D Mishra PhD

Gita D Mishra PhD

School of Public Health, University of Queensland, Brisbane, Queensland, Australia

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First published: 25 April 2018
Citations: 27
Funding information The InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). G.D.M. is supported by the Australian National Health and Medical Research Council Principal Research Fellowship (APP1121844). M.C.C.S.was supported by VicHealth and the Cancer Council, Victoria, Australia. D.N.C.S. was supported by the National Institute of Public Health, Copenhagen, Denmark. W.L.H.S. was funded by a grant from the Swedish Research Council (Grant number 521-2011-2955). N.S.H.D. and N.C.D.S. have core funding from the UK Medical Research Council (MC UU 12019/1) and UK Economic and Social Research Council, respectively. E.L.S.A. is funded by the National Institute on Aging (Grants 2RO1AG7644 and 2RO1AG017644-01A1) and a consortium of UK government departments. U.K.W.C.S. was originally funded by the World Cancer Research Fund

Abstract

Aim

To examine the prospective associations between aspects of a woman's reproductive history and incident diabetes.

Methods

We pooled individual data from 126 721 middle-aged women from eight cohort studies contributing to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE). Associations between age at menarche, age at first birth, parity and menopausal status with incident diabetes were examined using generalized linear mixed models, with binomial distribution and robust variance. We stratified by body mass index (BMI) when there was evidence of a statistical interaction with BMI.

Results

Over a median follow-up of 9 years, 4073 cases of diabetes were reported. Non-linear associations with diabetes were observed for age at menarche, parity and age at first birth. Compared with menarche at age 13 years, menarche at ≤10 years was associated with an 18% increased risk of diabetes (relative risk [RR] 1.18, 95% confidence interval [CI] 1.02-1.37) after adjusting for BMI. After stratifying by BMI, the increased risk was only observed in women with a BMI ≥25 kg/m2. A U-shaped relationship was observed between parity and risk of diabetes. Compared with pre-/peri-menopausal women, women with a hysterectomy/oophorectomy had an increased risk of diabetes (RR 1.17, 95% CI 1.07-1.29).

Conclusions

Several markers of a woman's reproductive history appear to be modestly associated with future risk of diabetes. Maintaining a normal weight in adult life may ameliorate any increase in risk conferred by early onset of menarche.