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The ECLIPSES trial was supported by the financially by the Spanish government's official funding agency for biomedical research, Instituto de Salud Carlos III (ISCIII), through the Fondo de Investigacion para la Salud (FIS) (Nos. PI12/ 02777 and PI17/01754) and co-funded by the European Union ERDF/ESF, "A way to make Europe"/"Investing in your future". These funding bodies played no part in designing the study, collecting and interpreting the data, or deciding to publish. A.D. is a Serra Hunter Fellow, Spain.

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Association of Parity With Insulin Resistance Early in Pregnant Women: ECLIPSES Study

Publicat a:Journal Of Clinical Endocrinology & Metabolism. 109 (3): 730-739 - 2024-01-01 109(3), DOI: 10.1210/clinem/dgad594

Autors: Motevalizadeh, Ehsan; Diaz-Lopez, Andres; Martin, Francisco; Basora, Josep; Arija, Victoria

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Little is known about whether parity is associated with elevated early-pregnancy IR, or whether overweight/obesity contributes to increasing the possible effect.We determined the associations between parity and glucose metabolism parameters in the first trimester of pregnancy in a Mediterranean pregnant population, and whether these associations are impacted by overweight/obesity.Cross-sectional study of 264 healthy pregnant women from the ECLIPSES study who were recruited at 12 weeks of gestation. At baseline, details on socio-economic status, obstetric history (including parity, i.e., number of births), lifestyle factors, anthropometry, and blood samples were collected. Fasting serum glucose, insulin, and HOMA-IR index were assessed in the first trimester. Elevated IR was defined as the upper HOMA-IR tertile (≥1.58). Multivariable linear regression and Cox regression model with constant time were performed.Parity ranged from 0-4. After multivariable adjustment, the insulin levels (β (% change): 20.92, 95%CI: 4.08, 37.71) and HOMA-IR index (β (% change): 19.72, 95%CI: 2.43, 40.49) were positively associated with parity. Additionally, multiparous women, as compared to nulliparous, were more likely to have higher HOMA-IR levels (primiparous (one birth), β (% change): 16.88, 95%CI: -1.00, 37.99; multiparous (≥2 two births), β (% change): 32.18, 95%CI: 3.56, 68.71), and an increased relative risk (RR) of an elevated IR (primiparous (one birth), RR: 1.55, 95%CI: 1.03, 2.36; multiparous (≥2 two births), RR: 1.72, 95%CI: 1.05, 2.83). The combination of multiparity and overweight/obesity conferred a 3.04-fold increase in the RR of elevated IR, which increased proportionally to the number of parities.This study demonstrates that parity may have a negative impact on early-pregnancy IR and that maternal overweight/obesity appears to further aggravate this relationship.© The Author(s) 2023. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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