Associations of Menstrual Cycle Characteristics Across the Reproductive Life Span and Lifestyle Factors With Risk of Type 2 Diabetes

Wang, Yi‐Xin; Shan, Zhilei; Arvizu, Mariel; Pan, An; Manson, JoAnn E.; Missmer, Stacey A.; Sun, Qi; Chavarro, Jorge E.

doi:10.1001/jamanetworkopen.2020.27928

Cited by 46 publications

(60 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interaction on the multiplicative scale was assessed by conducting likelihood ratio tests and on the additive scale by calculating the relative excess risk caused by interaction. 25 Several sensitivity analyses were conducted. First, we included never gravid women as a separate category to evaluate whether completing a pregnancy, rather than spontaneously losing a pregnancy, was responsible for the associations seen.…”

Section: Resultsmentioning

confidence: 99%

“…Interaction on the multiplicative scale was assessed by conducting likelihood ratio tests and on the additive scale by calculating the relative excess risk caused by interaction. 25 …”

Section: Methodsmentioning

confidence: 99%

“…Usual dietary intake, including alcohol consumption, was assessed with a semi-quantitative food frequency questionnaire every four years from 1991 17. Participants’ overall quality of their diet was evaluated by calculating the Alternative Healthy Eating Index, 2010 version 25. The reliability of self-reported gestational diabetes mellitus, hypertensive disorders of pregnancy, smoking habit, body weight, physical activity, and dietary intake has been validated in subgroups of participants from this cohort or similar nurses from the Nurses' Health Study 262728…”

Section: Methodsmentioning

confidence: 99%

“…We then tested for effect modification by gravidity, parity, pre-pregnancy body mass index, history of gestational diabetes mellitus and hypertensive disorders of pregnancy, parental history of cardiovascular disease, updated body mass index, quality score for diet, physical activity, and smoking status. Interaction on the multiplicative scale was assessed by conducting likelihood ratio tests and on the additive scale by calculating the relative excess risk caused by interaction 25…”

Section: Methodsmentioning

confidence: 99%

See 3 more Smart Citations

Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study

Wang

Mínguez-Alarcón

Gaskins

et al. 2021

BMJ

Self Cite

View full text Add to dashboard Cite

Objective To investigate the association of spontaneous abortion with the risk of all cause and cause specific premature mortality (death before the age of 70). Design Prospective cohort study. Setting The Nurses’ Health Study II (1993-2017), United States. Participants 101 681 ever gravid female nurses participating in the Nurses’ Health Study II. Main outcomes measures Lifetime occurrence of spontaneous abortion in pregnancies lasting less than 6 months, determined by biennial questionnaires. Hazard ratios and 95% confidence intervals for all cause and cause specific premature death according to the occurrence of spontaneous abortion, estimated with time dependent Cox proportional hazards models. Results During 24 years of follow-up, 2936 premature deaths were recorded, including 1346 deaths from cancer and 269 from cardiovascular disease. Crude all cause mortality rates were comparable for women with and without a history of spontaneous abortion (1.24 per 1000 person years in both groups) but were higher for women experiencing three or more spontaneous abortions (1.47 per 1000 person years) and for women reporting their first spontaneous abortion before the age of 24 (1.69 per 1000 person years). The corresponding age adjusted hazard ratios for all cause premature death during follow-up were 1.02 (95% confidence interval 0.94 to 1.11), 1.39 (1.03 to 1.86), and 1.27 (1.11 to 1.46), respectively. After adjusting for confounding factors and updated dietary and lifestyle factors, the occurrence of spontaneous abortion was associated with a hazard ratio of 1.19 (95% confidence interval 1.08 to 1.30) for premature mortality during follow-up. The association was stronger for recurrent spontaneous abortions (hazard ratio 1.59, 95% confidence interval 1.17 to 2.15 for three or more spontaneous abortions; 1.23, 1.00 to 1.50 for two; and 1.16, 1.05 to 1.28 for one compared with none), and for spontaneous abortions occurring early in a woman’s reproductive life (1.32, 1.14 to 1.53 for age ≤23; 1.16, 1.01 to 1.33 for ages 24-29; and 1.12, 0.98 to 1.28 for age ≥30 compared with none). When cause specific mortality was evaluated, the association of spontaneous abortion with premature death was strongest for deaths from cardiovascular disease (1.48, 1.09 to 1.99). Spontaneous abortion was not related to premature death from cancer (1.08, 0.94 to 1.24). Conclusions Spontaneous abortion was associated with an increased risk of premature mortality, particularly death from cardiovascular disease.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Interaction on the multiplicative scale was assessed by conducting likelihood ratio tests and on the additive scale by calculating the relative excess risk caused by interaction. 25 …”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study

Wang

Mínguez-Alarcón

Gaskins

et al. 2021

BMJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…However, irregular or long menstrual cycles, reflecting functional disruption of the neuroendocrine hypothalamic-pituitary-ovarian (HPO) axis, are estimated to affect nearly 20% of reproductive age women [7]. Menstrual cycle dysfunction has been associated with many endocrine-related diseases, including insulin resistance and type 2 diabetes [8][9][10]. However, evidence linking irregular or long menstrual cycles with GDM is scant and inconsistent [11,12].…”

Section: Introductionmentioning

confidence: 99%

Pre-pregnancy menstrual cycle regularity and length and the risk of gestational diabetes mellitus: prospective cohort study

Wang

Mitsunami

et al. 2021

Diabetologia

Self Cite

View full text Add to dashboard Cite

Aims/hypothesis Menstrual cycle dysfunction has been associated with many endocrine-related diseases, but evidence linking menstrual cycle dysfunction with gestational diabetes mellitus (GDM) is scant. The current study investigated the association of pre-pregnancy menstrual cycle regularity and length during adolescence, early adulthood and mid-adulthood with the subsequent risk of GDM. Methods Between 1993 and 2009, we followed 10,906 premenopausal women participating in the Nurses' Health Study II who reported menstrual cycle characteristics during adolescence (age 14-17 years), early adulthood (age 18-22 years) and midadulthood (age 29-46 years). Incident GDM was ascertained from a self-reported questionnaire regarding physician diagnosis. Log-binomial models with generalised estimating equations were used to estimate the RRs and 95% CI for the associations between menstrual cycle characteristics and GDM. Results We documented 578 incident cases of GDM among 14,418 pregnancies over a 16 year follow-up. After adjusting for potential confounders, women reporting always having irregular menstrual cycles during mid-adulthood had a 65% (95% CI 21, 125%) higher risk of GDM than women reporting very regular cycles. GDM risk was also greater among women reporting that their cycles were usually ≥32 days during mid-adulthood, compared with women reporting cycles between 26 and 31 days (RR 1.42 [95% CI 1.15, 1.75]). The risk of GDM was greater for women whose cycles changed from regular early in their reproductive years to irregular or from <32 days to ≥32 days during mid-adulthood, compared with women whose cycles remained <32 days or regular, respectively. Conclusions/interpretation Women whose cycles were long or irregular during mid-adulthood, but not in adolescence or young adulthood, were at higher risk of GDM.

show abstract

Association of Gestational Diabetes With Subsequent Long-Term Risk of Mortality

Wang,

Mitsunami,

Manson

et al. 2023

JAMA Intern Med

Self Cite

View full text Add to dashboard Cite

ImportanceGestational diabetes has been associated with numerous chronic diseases. However, few studies have examined the association of gestational diabetes with long-term mortality risk.ObjectiveTo investigate the associations between gestational diabetes and long-term risks of total and cause-specific mortality.Design, Setting, and ParticipantsThis cohort study analyzed participants of the Nurses’ Health Study II who were followed for 30 years (1989-2019). Participants included US female nurses aged 25 to 42 years who reported at least 1 pregnancy (≥6 months) at 18 years or older across their reproductive life span. Data were analyzed from May 1, 2022, to May 25, 2023.ExposureGestational diabetes across the reproductive life span.Main Outcomes and MeasuresHazard ratios (HRs with 95% CIs) for total and cause-specific mortality were estimated by Cox proportional hazards regression models.ResultsA total of 91 426 parous participants were included, with a mean (SD) age of 34.9 (4.7) years and a body mass index of 24.1 (4.7) at baseline. During a follow-up period of 2 609 753 person-years, 3937 deaths were documented, including 255 deaths from cardiovascular disease and 1397 from cancer. Participants with a history of gestational diabetes had a higher crude mortality rate than those without a history of gestational diabetes (1.74 vs 1.49 per 1000 person-years; absolute difference = 0.25 per 1000 person-years). The corresponding HR for total mortality was 1.28 (95% CI, 1.13-1.44), which did not materially change after additional adjustment for potential confounders and lifestyle factors during the reproductive life span (HR, 1.25; 95% CI, 1.11-1.41). The association persisted regardless of the subsequent development of type 2 diabetes and was more robust among participants who adopted less healthy lifestyles; experienced gestational diabetes in 2 or more pregnancies (HR, 1.48; 95% CI, 0.99-2.19); had gestational diabetes both in the initial and subsequent pregnancies (HR, 1.71; 95% CI, 1.11-2.63); and concurrently reported hypertensive disorders in pregnancy (HR, 1.80; 95% CI, 1.21-2.67), preterm birth (HR, 2.46; 95% CI, 1.66-3.64), or low birth weight (HR, 2.11; 95% CI, 1.21-3.68). Cause-specific mortality analyses revealed that gestational diabetes was directly associated with the risk of mortality due to cardiovascular disease (HR, 1.59; 95% CI, 1.03-2.47). Additionally, gestational diabetes was inversely associated with cancer mortality (HR, 0.76; 95% CI, 0.59-0.98); however, it was only evident among participants who later developed type 2 diabetes.Conclusions and RelevanceResults of this cohort study suggest that participants who reported a history of gestational diabetes exhibited a small but elevated risk of subsequent mortality over 30 years. The findings emphasize the importance of considering gestational diabetes as a critical factor in later-life mortality risk.

show abstract

Associations of Menstrual Cycle Characteristics Across the Reproductive Life Span and Lifestyle Factors With Risk of Type 2 Diabetes

Cited by 46 publications

References 33 publications

Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study

Association of spontaneous abortion with all cause and cause specific premature mortality: prospective cohort study

Pre-pregnancy menstrual cycle regularity and length and the risk of gestational diabetes mellitus: prospective cohort study

Association of Gestational Diabetes With Subsequent Long-Term Risk of Mortality

Contact Info

Product

Resources

About