title: Number of children and change in markers of metabolic health over 9-years in men and women. Data from the DESIR study.
abstract: OBJECTIVE
  Parity is associated with an increased risk of coronary heart disease and type 2 diabetes, possibly mediated by long-term modification of metabolic health. Studying associations between the number of children with health and disease in men in addition to women allows for differentiation between the social and lifestyle influences of child-rearing, and the biological influences of childbearing. We sought to determine whether the number of children is associated with the incidence of raised fasting glucose (fasting plasma glucose≥6.1 mmol/L) and changes in glucose, insulin, insulin resistance and β-cell function over 9-years.
  
  
  METHODS
  Analysis of 1798 women and 1737 men from the DESIR study.
  
  
  RESULTS
  The number of children was associated with change in fasting glucose for women (P(trend)=0.02) and men (P(trend)=0.03), and increased incidence of raised fasting glucose by 30% (95% CI: 15, 47%) per child for men, but not women (3% [95% CI: -8, 15%]). There was a J-shaped association between number of children and change in insulin (P=0.01) and insulin resistance (P=0.005) for women, and a reduction in β-cell function in parous women (P=0.07). Men with children had increases in insulin (P=0.02), insulin resistance (P=0.02), and β-cell function (P=0.07).
  
  
  CONCLUSIONS
  The number of children a person has is associated with changes in metabolic health indices long after childbirth for both men and women. The distinct gender differences in deterioration of metabolic health indices emphasize that childbearing and child-rearing are likely to have differential influences on metabolic health.
authors.affiliation: Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia. michael.skilton@sydney.edu.au
authors.forename: M R
authors.initials: MR
authors.lastname: Skilton
authors.forename: C
authors.initials: C
authors.lastname: Lange
authors.forename: O
authors.initials: O
authors.lastname: Lantieri
authors.forename: B
authors.initials: B
authors.lastname: Balkau
authors.forename: F
authors.initials: F
authors.lastname: Bonnet
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D005220:Fathers / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009035:Mothers / Q000706:statistics & numerical data*; D009043:Motor Activity; D010298:Parity; D012044:Regression Analysis; D012907:Smoking / Q000097:blood / Q000453:epidemiology / Q000378:metabolism
chemical_list: D015415:Biomarkers; D001786:Blood Glucose