Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes

Yun Shen; Junhong Leng; Weiqin Li; Shuang Zhang; Huikun Liu; Ping Shao; Peng Wang; Leishen Wang; Huiguang Tian; Cuilin Zhang; Xilin Yang; Zhijie Yu; Lifang Hou; Jaakko Tuomilehto; Gang Hu

doi:10.1002/dmrr.3115

Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes

Yun Shen, Junhong Leng, Weiqin Li, Shuang Zhang, Huikun Liu, Ping Shao, Peng Wang, Leishen Wang, Huiguang Tian, Cuilin Zhang, Xilin Yang, Zhijie Yu, Lifang Hou, Jaakko Tuomilehto, Gang Hu

Medicine

Medicine

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Resumen

Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (P_trend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (P_trend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (P_trend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (P_trend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (P_trend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

Idioma original	English
Número de artículo	e3115
Publicación	Diabetes/Metabolism Research and Reviews
Volumen	35
N.º	3
DOI	https://doi.org/10.1002/dmrr.3115
Estado	Published - mar. 2019

Nota bibliográfica

Funding Information:
We would like to appreciate all families for participating in the Tianjin Gestational Diabetes Mellitus Prevention Program.

Funding Information:
This study is supported by the grant from European Foundation for the Study of Diabetes (EFSD)/Chinese Diabetes Society (CDS)/Lilly programme for Collaborative Research between China and Europe, Tianjin Women's and Children's Health Center, and Tianjin Public Health Bureau. Dr. Hu was partly supported by the grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790) and the National Institute of General Medical Sciences (U54GM104940) of the National Institutes of Health.

Publisher Copyright:
© 2018 John Wiley & Sons, Ltd.

ASJC Scopus Subject Areas

Internal Medicine
Endocrinology, Diabetes and Metabolism
Endocrinology

PubMed: MeSH publication types

Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

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Shen, Y., Leng, J., Li, W., Zhang, S., Liu, H., Shao, P., Wang, P., Wang, L., Tian, H., Zhang, C., Yang, X., Yu, Z., Hou, L., Tuomilehto, J., & Hu, G. (2019). Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes. Diabetes/Metabolism Research and Reviews, 35(3), Artículo e3115. https://doi.org/10.1002/dmrr.3115

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title = "Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes",

abstract = "Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.",

author = "Yun Shen and Junhong Leng and Weiqin Li and Shuang Zhang and Huikun Liu and Ping Shao and Peng Wang and Leishen Wang and Huiguang Tian and Cuilin Zhang and Xilin Yang and Zhijie Yu and Lifang Hou and Jaakko Tuomilehto and Gang Hu",

note = "Funding Information: We would like to appreciate all families for participating in the Tianjin Gestational Diabetes Mellitus Prevention Program. Funding Information: This study is supported by the grant from European Foundation for the Study of Diabetes (EFSD)/Chinese Diabetes Society (CDS)/Lilly programme for Collaborative Research between China and Europe, Tianjin Women's and Children's Health Center, and Tianjin Public Health Bureau. Dr. Hu was partly supported by the grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790) and the National Institute of General Medical Sciences (U54GM104940) of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2018 John Wiley & Sons, Ltd.",

year = "2019",

month = mar,

doi = "10.1002/dmrr.3115",

language = "English",

volume = "35",

journal = "Diabetes/Metabolism Research and Reviews",

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TY - JOUR

T1 - Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes

AU - Shen, Yun

AU - Leng, Junhong

AU - Li, Weiqin

AU - Zhang, Shuang

AU - Liu, Huikun

AU - Shao, Ping

AU - Wang, Peng

AU - Wang, Leishen

AU - Tian, Huiguang

AU - Zhang, Cuilin

AU - Yang, Xilin

AU - Yu, Zhijie

AU - Hou, Lifang

AU - Tuomilehto, Jaakko

AU - Hu, Gang

N1 - Funding Information: We would like to appreciate all families for participating in the Tianjin Gestational Diabetes Mellitus Prevention Program. Funding Information: This study is supported by the grant from European Foundation for the Study of Diabetes (EFSD)/Chinese Diabetes Society (CDS)/Lilly programme for Collaborative Research between China and Europe, Tianjin Women's and Children's Health Center, and Tianjin Public Health Bureau. Dr. Hu was partly supported by the grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100790) and the National Institute of General Medical Sciences (U54GM104940) of the National Institutes of Health. Publisher Copyright: © 2018 John Wiley & Sons, Ltd.

PY - 2019/3

Y1 - 2019/3

N2 - Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

AB - Objective: To investigate the association of lactation intensity and duration with postpartum diabetes and prediabetes risks among Chinese women with a history of gestational diabetes (GDM). Methods: We included 1260 women with a history of GDM who participated in the whole population's GDM universal screening survey by using the 1999 World Health Organization's criteria. Lactation intensity and lactation duration were collected by a standardized questionnaire. Postpartum diabetes and prediabetes risk were confirmed by an oral glucose tolerance test. Results: During a mean postpartum period of 3.65 years, we identified 114 cases of diabetes and 417 cases of prediabetes. The multivariable-adjusted hazard ratios based on different lactation intensity (exclusive formula, mixed feeding, and exclusive lactation) were 1.00, 0.68, 0.45 for diabetes (Ptrend = 0.008), and 1.00, 0.74, and 0.61 for prediabetes (Ptrend = 0.006), respectively. The multivariable-adjusted hazard ratios associated with different lactation duration (none, 0-6 months, 6-12 months, 12-18 months, and ≥18 months) were 1.00, 0.66, 0.42, 0.66, and 0.25 for diabetes (Ptrend = 0.013), and 1.00, 0.82, 0.62, 0.67, and 0.63 for prediabetes (Ptrend = 0.021), respectively. A restricted cubic spline curve showed a graded inverse association of lactation duration with the risks of diabetes and prediabetes (Ptrend < 0.001). Conclusions: Higher-lactation intensity and longer-lactation duration were significantly associated with lower risks of postpartum diabetes and prediabetes among Chinese women with a history of GDM.

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Lactation intensity and duration to postpartum diabetes and prediabetes risk in women with gestational diabetes

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PubMed: MeSH publication types

ODS de las Naciones Unidas

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