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

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 cm(3)), 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.