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Biomedical subjects

E B Rimm

Publications and source records attributed to E B Rimm.

At least 163 records · Page 9Linked to original sources
PubMed1994

Risk factors for hip fracture in US men aged 40 through 75 years.

Relatively few studies have examined risk factors for hip fracture among men. This study analyzes data from the Health Professionals Follow-up Study, a prospective study of approximately 50,000 men who were between the ages of 40 and 75 years in 1986. Body mass index, smoking status, and alcohol consumption were not associated with hip fracture in this population. However, age and height were related to hip fracture. Men who were 65 and older had a significantly higher risk of sustaining a hip fracture than younger adults. Men 6 feet or taller were more than twice as likely to sustain a hip fracture as those under 5 feet, 9 inches.

Adult↗
PubMed1994

Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men.

OBJECTIVE: To investigate the relation between obesity, fat distribution, and weight gain through adulthood and the risk of non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: We analyzed data from a cohort of 51,529 U.S. male health professionals, 40-75 years of age in 1986, who completed biennial questionnaires sent out in 1986, 1988, 1990, and 1992. During 5 years of follow-up (1987-1992), 272 cases of NIDDM were diagnosed among men without a history of diabetes, heart disease, and cancer in 1986 and who provided complete health information. Relative risks (RRs) associated with different anthropometric measures were calculated controlling for age, and multivariate RRs were calculated controlling for smoking, family history of diabetes, and age. RESULTS: We found a strong positive association between overall obesity as measured by body mass index (BMI) and risk of diabetes. Men with a BMI of > or = 35 kg/m2 had a multivariate RR of 42.1 (95% confidence interval [CI] 22.0-80.6) compared with men with a BMI < 23.0 kg/m2. BMI at age 21 and absolute weight gain throughout adulthood were also significant independent risk factors for diabetes. Fat distribution, measured by waist-to-hip ratio (WHR), was a good predictor of diabetes only among the top 5%, while waist circumference was positively associated with the risk of diabetes among the top 20% of the cohort. CONCLUSIONS: These data suggest that waist circumference may be a better indicator than WHR of the relationship between abdominal adiposity and risk of diabetes. Although early obesity, absolute weight gain throughout adulthood, and waist circumference were good predictors of diabetes, attained BMI was the dominant risk factor for NIDDM; even men of average relative weight had significantly elevated RRs.

Adult↗
PubMed1994

Patient-controlled analgesia and postoperative urinary retention after hysterectomy for benign disease.

BACKGROUND: Because postoperative urinary retention can result in considerable morbidity and the rate of retention after hysterectomy has recently increased at our institutions, we conducted a study to determine risk factors for the disorder. STUDY DESIGN: A cohort of 366 consecutive patients who had undergone uncomplicated abdominal or vaginal hysterectomy for benign disease and who met strict inclusion criteria were studied retrospectively by means of a review of their medical records. Student's t test and multivariate logistic regression analysis were used to assess the effects of operative time, amount of fluid given perioperatively, type and amount of analgesic agent administered postoperatively, age of the patient, performance of a vaginal versus an abdominal hysterectomy, and the postoperative use of patient-controlled analgesia on the rate of postoperative urinary retention in these patients. RESULTS: After adjustment for confounding factors, only the use of patient-controlled analgesia (p = 0.0001) and vaginal hysterectomy (p = 0.0003) were significantly related to postoperative urinary retention. Patients who used patient-controlled analgesia were 5.7 times (95 percent confidence interval, 2.6 to 12.4) more likely to have urinary retention than those given an intramuscular agent. CONCLUSIONS: Urinary retention after hysterectomy might be avoided by administering analgesic agents intramuscularly or inserting a suprapubic cystostomy catheter postoperatively, especially in patients who have undergone a vaginal procedure.

Adult↗
PubMed1993

A prospective study of dietary fat and risk of prostate cancer.

BACKGROUND: The strong correlation between national consumption of fat and national rate of mortality from prostate cancer has raised the hypothesis that dietary fat increases the risk of this malignancy. Case-control and cohort studies have not consistently supported this hypothesis. PURPOSE: We examined prospectively the relationship between prostate cancer and dietary fat, including specific fatty acids and dietary sources of fat. We examined the relationship of fat consumption to the incidence of advanced prostate cancer (stages C, D, or fatal cases) and to the total incidence of prostate cancer. METHODS: We used data from the Health Professionals Follow-up Study, which is a prospective cohort of 51529 U.S. men, aged 40 through 75, who completed a validated food-frequency questionnaire in 1986. We sent follow-up questionnaires to the entire cohort in 1988 and 1990 to document new cases of a variety of diseases and to update exposure information. As of January 31, 1990, 300 new cases of prostate cancer, including 126 advanced cases, were documented in 47855 participants initially free of diagnosed cancer. The Mantel-Haenszel summary estimator was used to adjust for age and other potentially confounding variables. Multiple logistic regression was used to estimate relative risks (RRs) when controlling simultaneously for more than two covariates. RESULTS: Total fat consumption was directly related to risk of advanced prostate cancer (age- and energy-adjusted RR = 1.79, with 95% confidence interval [CI] = 1.04-3.07, for high versus low quintile of intake; P [trend] = .06). This association was due primarily to animal fat (RR = 1.63; 95% CI = 0.95-2.78; P [trend] = .08), but not vegetable fat. Red meat represented the food group with the strongest positive association with advanced cancer (RR = 2.64; 95% CI = 1.21-5.77; P = .02). Fat from dairy products (with the exception of butter) or fish was unrelated to risk. Saturated fat, monounsaturated fat, and alpha-linolenic acid, but not linoleic acid, were associated with advanced prostate cancer risk; only the association with alpha-linolenic acid persisted when saturated fat, monounsaturated fat, linoleic acid, and alpha-linolenic acid were modeled simultaneously (multivariate RR = 3.43; 95% CI = 1.67-7.04; P [trend] = .002). CONCLUSION: The results support the hypothesis that animal fat, especially fat from red meat, is associated with an elevated risk of advanced prostate cancer. IMPLICATIONS: These findings support recommendations to lower intake of meat to reduce the risk of prostate cancer. The potential roles of carcinogens formed in cooking animal fat and of alpha-linolenic acid in the progression of prostate cancer need to be explored.

Adult↗
PubMed1993

Folate, methionine, and alcohol intake and risk of colorectal adenoma.

BACKGROUND: Reduced methylation of DNA may contribute to loss of the normal controls on proto-oncogene expression. In humans, hypomethylation of DNA has been observed in colorectal cancers and in their adenomatous polyp precursors. Accumulation of DNA methylation abnormalities, observed during progression of human colorectal neoplasia, may be influenced by certain dietary factors. The apparent protective effect of fresh fruits and vegetables, the major folate sources, on colorectal cancer incidence suggests that a methyl-deficient diet contributes to occurrence of this malignancy. Low dietary folate and methionine and high intake of alcohol may reduce levels of S-adenosylmethionine, which is required for DNA methylation. PURPOSE: To determine if dietary factors that may influence methyl availability are related to colorectal adenomas, we prospectively examined the association of folate, methionine, and alcohol intakes and risk of colorectal adenoma. METHODS: We assessed dietary intake for a 1-year period for women of the Nurses' Health Study, started in 1976, and for men of the Health Professionals Follow-up Study, started in 1986--using a semiquantitative food frequency questionnaire. Adenomatous polyps of the left colon or rectum were diagnosed in 564 of 15,984 women who had had an endoscopy between 1980 and 1990 and in 331 of 9490 men who had undergone an endoscopy between 1986 and 1990. RESULTS: High dietary folate was inversely associated with risk of colorectal adenoma in women (multivariate relative risk [RR] = 0.66; 95% confidence interval [CI] = 0.46-0.95 between high and low quintiles of intake) and in men (RR = 0.63; 95% CI = 0.41-0.98) after adjusting for age, family history, indications for endoscopy, history of previous endoscopy, total energy intake, saturated fat intake, dietary fiber, and body mass index. Relative to nondrinkers, drinkers of more than 30 g of alcohol daily (about two drinks) had an elevated risk of adenoma (in women, RR = 1.84, 95% CI = 1.19-2.86; in men, RR = 1.64, 95% CI = 0.92-2.93). Methionine intake was inversely associated with risk of adenomas 1 cm or larger (RR = 0.62; 95% CI = 0.46-0.85, combining men and women). CONCLUSIONS: Folate, alcohol, and methionine could influence methyl group availability, and a methyl-deficient diet may be linked to early stages of colorectal neoplasia. A dietary pattern that increases methyl availability could reduce incidence of colorectal cancer. IMPLICATIONS: These data support efforts to increase dietary folate in segments of the population having diets with low intakes of this nutrient.

Adenoma↗
PubMed1993

Vitamin E consumption and the risk of coronary heart disease in men.

BACKGROUND: The oxidative modification of low-density lipoproteins increases their incorporation into the arterial intima, an essential step in atherogenesis. Although dietary antioxidants, such as vitamin C, carotene, and vitamin E, have been hypothesized to prevent coronary heart disease, prospective epidemiologic data are sparse. METHODS: In 1986, 39,910 U.S. male health professionals 40 to 75 years of age who were free of diagnosed coronary heart disease, diabetes, and hypercholesterolemia completed detailed dietary questionnaires that assessed their usual intake of vitamin C, carotene, and vitamin E in addition to other nutrients. During four years of follow-up, we documented 667 cases of coronary disease. RESULTS: After controlling for age and several coronary risk factors, we observed a lower risk of coronary disease among men with higher intakes of vitamin E (P for trend = 0.003). For men consuming more than 60 IU per day of vitamin E, the multivariate relative risk was 0.64 (95 percent confidence interval, 0.49 to 0.83) as compared with those consuming less than 7.5 IU per day. As compared with men who did not take vitamin E supplements, men who took at least 100 IU per day for at least two years had a multivariate relative risk of coronary disease of 0.63 (95 percent confidence interval, 0.47 to 0.84). Carotene intake was not associated with a lower risk of coronary disease among those who had never smoked, but it was inversely associated with the risk among current smokers (relative risk, 0.30; 95 percent confidence interval, 0.11 to 0.82) and former smokers (relative risk, 0.60; 95 percent confidence interval, 0.38 to 0.94). In contrast, a high intake of vitamin C was not associated with a lower risk of coronary disease. CONCLUSIONS: These data do not prove a causal relation, but they provide evidence of an association between a high intake of vitamin E and a lower risk of coronary heart disease in men. Public policy recommendations with regard to the use of vitamin E supplements should await the results of additional studies.

Adult↗
PubMed1993

A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones.

BACKGROUND: A high dietary calcium intake is strongly suspected of increasing the risk of kidney stones. However, a high intake of calcium can reduce the urinary excretion of oxalate, which is thought to lower the risk. The concept that a higher dietary calcium intake increases the risk of kidney stones therefore requires examination. METHODS: We conducted a prospective study of the relation between dietary calcium intake and the risk of symptomatic kidney stones in a cohort of 45,619 men, 40 to 75 years of age, who had no history of kidney stones. Dietary calcium was measured by means of a semiquantitative food-frequency questionnaire in 1986. During four years of follow-up, 505 cases of kidney stones were documented. RESULTS: After adjustment for age, dietary calcium intake was inversely associated with the risk of kidney stones; the relative risk of kidney stones for men in the highest as compared with the lowest quintile group for calcium intake was 0.56 (95 percent confidence interval, 0.43 to 0.73; P for trend, < 0.001). This reduction in risk decreased only slightly (relative risk, 0.66; 95 percent confidence interval, 0.49 to 0.90) after further adjustment for other potential risk factors, including alcohol consumption and dietary intake of animal protein, potassium, and fluid. Intake of animal protein was directly associated with the risk of stone formation (relative risk for men with the highest intake as compared with those with the lowest, 1.33; 95 percent confidence interval, 1.00 to 1.77); potassium intake (relative risk, 0.49; 95 percent confidence interval, 0.35 to 0.68) and fluid intake (relative risk, 0.71; 95 percent confidence interval, 0.52 to 0.97) were inversely related to the risk of kidney stones. CONCLUSIONS: A high dietary calcium intake decreases the risk of symptomatic kidney stones.

Adult↗
PubMed1993

A prospective cohort study of vasectomy and prostate cancer in US men.

OBJECTIVE: To examine prospectively the relationship between vasectomy and prostate cancer. DESIGN: Cohort study. SETTING: Health professionals (dentists, veterinarians, osteopaths, optometrists, pharmacists, and podiastrists) in the United States. PARTICIPANTS: There were 10,055 male members of the Health Professionals Follow-up Study, aged 40 to 75 years, who had had a vasectomy, and 37,800 members who had not had a vasectomy at the time of study entry in 1986. These participants had provided detailed information on various life-style variables including diet. MAIN OUTCOME MEASURE: Diagnosis of prostate cancer. RESULTS: Between 1986 and 1990, 300 new cases of prostate cancer were diagnosed in participants who were initially free of diagnosed cancer. Vasectomy was associated with an elevated risk of prostate cancer (age-adjusted relative risk, 1.66; 95% confidence interval, 1.25 to 2.21; P = .0004). This elevated risk persisted after excluding 21 stage A1 cases (age-adjusted relative risk, 1.56; 95% confidence interval, 1.15 to 2.11; P = .004). Among men who had their vasectomy at least 22 years in the past (before 1965), the risk of prostate cancer was even higher (relative risk, 1.85; 95% confidence interval, 1.26 to 2.72; P = .002). This elevated risk among men with vasectomy did not appear to be caused by detection bias and persisted when we controlled for diet, level of physical activity, smoking, alcohol consumption, educational level, body mass index, and geographical area of residence. CONCLUSIONS: These results support evidence from other epidemiologic studies that vasectomy increases risk of prostate cancer. The consistency of results among various epidemiologic studies, the increase of risk over time following vasectomy, the apparent lack of confounding or bias, and the existence of physiological changes in the prostate following vasectomy suggest that the association may be causal.

Adult↗
PubMed1993

Reproducibility and validity of food intake measurements from a semiquantitative food frequency questionnaire.

Few food frequency questionnaires have been evaluated for their ability to assess intakes of individual foods that may be related to disease independently of their nutrient content. The reproducibility and validity of food intake measurements by a 131-item semiquantitative food frequency questionnaire were evaluated in a sample of 127 men from the Health Professionals Follow-up Study, a large longitudinal study of diet and disease. Each subject completed two questionnaires 1 year apart and two 1-week diet records 6 months apart during the intervening year. Pearson correlations assessing reproducibility between food intakes from the two questionnaires ranged from .31 for pie to .92 for coffee (mean = .59). Validity was measured by comparing food intakes from the second questionnaire with those from the diet records. Pearson correlations corrected for within-person weekly variation in diet record data ranged from .17 for other nuts to .95 for bananas (mean = .63). Large within-person variation precluded the calculation of accurate validity correlations for 29 foods. As we previously observed in women, the foods most often overreported were fruits and vegetables, and meats and dairy products were most often underreported. With few exceptions, reasonable levels of reproducibility and validity were observed for intake of individual foods in this extensive food frequency questionnaire.

Adult↗
PubMed1993

Cigarette smoking and the risk of diabetes in women.

OBJECTIVES: Noninsulin-dependent diabetes mellitus, a major risk factor for cardiovascular disease, is prevalent in more than 12 million Americans. A voluminous amount of data demonstrates that cigarette smoking is an important cause of cancer and coronary heart disease. However, the association between cigarette smoking and the risk of diabetes is virtually unexplored, especially in women. METHODS: We examined the association between smoking and the incidence of noninsulin-dependent diabetes mellitus among 114,247 female nurses who were free of diabetes, cardiovascular disease, and cancer in 1976. We collected exposure information and disease status prospectively for 12 years from biennially self-administered questionnaires. RESULTS: Current smokers had an increased risk of diabetes, and we observed a significant dose-response trend for higher risk among heavier smokers. During 1,277,589 person-years of follow-up, 2333 women were clinically diagnosed with diabetes. The relative risk of diabetes, adjusted for obesity and other risk factors, was 1.42 among women who smoked 25 or more cigarettes per day compared with nonsmokers. CONCLUSIONS: These data suggest that cigarette smoking may be an independent, modifiable risk factor for noninsulin-dependent diabetes mellitus.

Adult↗
PubMed1993

Clinical presentation of chronic anal fissures.

Chronic anal fissures have a varied and often confusing clinical presentation. To clarify this picture, we retrospectively studied 172 patients to determine associations between patient characteristics and manifestations of these lesions. We found that anterior fissures and sentinel piles were significantly more common in women; pruritus and rectal drainage occurred significantly more often in men; and patients with a longer duration of symptoms and those with pruritus and drainage were more likely to have a fistula. Younger patients were more likely to report rectal bleeding. Patients with chronic anal pruritus or an anal abscess should be carefully evaluated for an anal fistula, since anorectal problems may recur if a fistula remains untreated.

Abscess↗
PubMed1993

Patient-controlled analgesia and postoperative urinary retention after open appendectomy.

We retrospectively studied 279 patients who had undergone uncomplicated open appendectomy for acute appendicitis to determine risk factors for postoperative urinary retention. The gender of the patients, the operating time and the amount of fluid given perioperatively had no influence on the occurrence of retention. The amount of analgesic agent administered postoperatively and the age of the patient were significantly associated with urinary retention (p = 0.01 and p < 0.0001, respectively, after adjustment for potential confounding factors). The use of meperidine hydrochloride as compared with morphine and of patient-controlled analgesia as compared with intramuscular delivery were initially found to be significantly related to retention (p = 0.014 and p < 0.0001, respectively). After the effects of the age of the patient, the drug type and the amount of fluid and analgesic agent administered were controlled for, patient-controlled analgesia remained significantly associated with retention (p < 0.0001), whereas the type of drug given was no longer significant after controlling for potential confounding factors. Because we found that urinary retention was 13 times more likely to occur in the patients who had patient-controlled analgesia, we recommend that the use of this form of analgesia delivery be avoided after open appendectomy.

Adolescent↗
PubMed1992

Reproducibility and validity of an expanded self-administered semiquantitative food frequency questionnaire among male health professionals.

The authors assessed the reproducibility and validity of an expanded 131-item semiquantitative food frequency questionnaire used in a prospective study among 51,529 men. The form was administered by mail twice to a sample of 127 participants at a one-year interval. During this interval, men completed two one-week diet records spaced approximately 6 months apart. Mean values for intake of most nutrients assessed by the two methods were similar. Intraclass correlation coefficients for nutrient intakes assessed by questionnaires one year apart ranged from 0.47 for vitamin E without supplements to 0.80 for vitamin C with supplements. Correlation coefficients between the energy-adjusted nutrient intakes measured by diet records and the second questionnaire (which asked about diet during the year encompassing the diet records) ranged from 0.28 for iron without supplements to 0.86 for vitamin C with supplements (mean r = 0.59). These correlations were higher after adjusting for week-to-week variation in diet record intakes (mean r = 0.65). These data indicate that the expanded semiquantitative food frequency questionnaire is reproducible and provides a useful measure of intake for many nutrients over a one-year period.

Age Factors↗
PubMed1992

Comparison of measures of fatty acid intake by subcutaneous fat aspirate, food frequency questionnaire, and diet records in a free-living population of US men.

In 1986-1987, the authors assessed the fatty acid intake of 118 Boston-area men, aged 40-75 years, by a semiquantitative food frequency questionnaire administered twice, by two 7-day diet records, and by capillary gas chromatography of subcutaneous fat samples obtained by needle aspirate from the lateral buttock. Spearman correlation coefficients between diet record estimates of fatty acid intake (as a percentage of total fat) and fat aspirate measures (as a percentage of total peak area) were as follows: saturated fat, r = 0.16 (p = 0.09); monounsaturated fat, r = 0.22 (p = 0.01); and polyunsaturated fat, r = 0.49 (p = 0.0001). Spearman correlation coefficients between estimates derived from the food frequency questionnaire were as follows: saturated fat, r = 0.18 ( p = 0.05); monounsaturated fat, r = 0.14 (p = 0.14); polyunsaturated fat, r = 0.50 (p = 0.0001); and eicosapentaenoic acid, r = 0.47 (p = 0.0001). These data confirm that the polyunsaturated and eicosapentaenoic fatty acid content of subcutaneous fat is a measure of dietary intake of these fats. Although diet records are commonly thought to be the "gold standard" method of dietary assessment, the similar correlations observed between the fatty acid composition of adipose tissue and estimates of intake from the food frequency questionnaire and from diet records suggest that these two dietary assessment methods have similar validity in the measurement of polyunsaturated fatty acid intake.

Adipose Tissue↗
PubMed1992

Relationship of diet to risk of colorectal adenoma in men.

BACKGROUND: Rates of colorectal cancer in various countries are strongly correlated with per-capita consumption of red meat and animal fat and inversely associated with fiber consumption. There have been few studies, however, of dietary risk factors for colorectal adenomas, which are precursors of cancer. PURPOSE: Our purpose was to determine prospectively the relationship between dietary factors and risk of colorectal adenomas. METHODS: Using data from the Health Professionals Follow-up Study, we documented 170 cases of adenomas of the left colon or rectum in 7284 male health professionals who completed a food-frequency questionnaire in 1986 and who had a colonoscopy or sigmoidoscopy between 1986 and 1988. Relative risk (RR) of adenoma was determined according to quintiles of nutrient intakes. RESULTS: After adjustment for total energy intake, saturated fat was positively associated with risk of colorectal adenoma (P for trend = .006); RR for the highest versus the lowest quintile of intake was 2.0 (95% confidence interval [CI] = 1.2-3.2). Dietary fiber was inversely associated with risk of adenoma (P for trend less than .0001); RR for men in the highest versus the lowest quintile was 0.36 (95% CI = 0.22-0.60). All sources of fiber (vegetables, fruits, and grains) were associated with decreased risk of adenoma. For subjects on a high-saturated fat, low-fiber diet, the RR was 3.7 (95% CI = 1.5-8.8) compared with those on a low-saturated fat, high-fiber diet. The ratio of the intake of red meat to the intake of chicken and fish was positively associated with risk of adenoma (P for trend = .02). CONCLUSIONS: These prospective data provide evidence for the hypothesis that a diet high in saturated fat and low in fiber increases the risk of colorectal adenoma. They also support existing recommendations to substitute chicken and fish for red meat in the diet and to increase intake of vegetables, fruits, and grains to reduce risk of colorectal cancer.

Adult↗
PubMed1992

Oral contraceptive use and the risk of type 2 (non-insulin-dependent) diabetes mellitus in a large prospective study of women.

We examined the association between oral contraceptive use and incidence of Type 2 (non-insulin-dependent) diabetes mellitus among 115117 female nurses free of diabetes, cardiovascular disease and cancer in 1976 and followed-up for 12 years. During 1237440 person years of follow-up, 2276 women who provided information on oral contraceptive use were clinically diagnosed with Type 2 diabetes. Women who used oral contraceptives in the past had only a slight and marginally increased relative risk of 1.10 (95% confidence interval 1.01, 1.21) compared to those women who had never used oral contraceptives after controlling for known risk factors of disease. We found no evidence of increased risk with longer duration of use or with shorter interval since last use. Current users did not have an increased risk of Type 2 diabetes (relative risk = 0.86, 95% confidence interval 0.46, 1.61) when compared to women who had never used the drug. There was no effect modification by obesity, family history of diabetes, or physical activity. These data suggest that past or current oral contraceptive use does not substantially influence subsequent risk of Type 2 diabetes.

Adult↗
PubMed1992

Parity and incidence of non-insulin-dependent diabetes mellitus.

PURPOSE: To examine prospectively the association between parity and subsequent incidence of non-insulin-dependent diabetes mellitus (NIDDM). Most previous studies have not controlled for potential confounding by age and obesity. PATIENTS AND METHODS: In a prospective cohort study, 113,606 United States registered nurses aged 30 to 55 years and free of diagnosed diabetes, coronary heart disease, stroke, and cancer at baseline were followed for 12 years. Endpoint was incidence of confirmed NIDDM. RESULTS: During 1,278,188 person-years of follow-up, we confirmed 2,310 incident cases of NIDDM. An apparent association between parity and diabetes was observed in unadjusted analyses (relative risk = 1.56 [95% confidence interval (CI), 1.27 to 1.91] among women with six or more births compared with that in nulliparous women) (p, trend less than 0.00001). This association was attenuated after adjustment for age (relative risk = 1.19 [CI 0.97 to 1.48], p, trend = 0.06) and was completely abolished after adjustment for both age and body mass index (relative risk = 0.95 [CI 0.75 to 1.19], p, trend = 0.19). Multivariate adjustment for family history of diabetes, age at first birth, hormone use, and other variables did not materially alter these findings. There was no important modifying effect of family history of diabetes on these associations. CONCLUSIONS: Despite a temporary diabetogenic effect of pregnancy, parity is not associated with an increased risk of subsequent clinical NIDDM. These data underscore the importance of control for confounding by age and obesity in evaluating these associations.

Adult↗