The use of oral contraceptive is inversely associated with the risk of type 2 diabetes mellitus among middle-aged women

Abstract

Objective

To assess the cross-sectional association between oral contraceptive (OC) use and type 2 diabetes mellitus (T2DM) risk among US women.

Methods

The data was obtained from the National Health and Nutrition Examination Survey (NHANES 2007–2018). OC use was assessed by questionnaires and the diagnosis of T2DM was confirmed by the glycosylated hemoglobin, fasting blood glucose, and self-report. Binary logistic regression models and the restricted cubic spline model were adopted to evaluate whether OC use was associated with T2DM.

Results

Compared with non-users, the odds ratio (OR) with 95% confidence interval (CI) of T2DM risk for the OC users was 0.71 (0.57–0.89) in unadjusted Model. The association remained significant in fully adjusted models, and the OR with 95%CI was 0.78 (0.62–0.99). In the stratified analyses, there was an inverse association of OC use with T2DM risk when women were overweight. Dose-response analysis also revealed an inversely nonlinear relationship between the duration of OC use and T2DM (p-value for linearity = .589).

Conclusions

Our findings suggested that OC use may be inversely associated with T2DM risk.

中年女性口服避孕药的使用与2型糖尿病风险呈负相关 摘要

目的：评估美国女性口服避孕药（oral contraceptive, OC）的使用与2型糖尿病（type 2 diabetes mellitus, T2DM）风险之间的横断面关系。

方法：数据来源于美国国家健康与营养调查（National Health and Nutrition Examination Survey , NHANES）2007-2018。通过问卷调查评估OC的使用情况, 并通过糖化血红蛋白、空腹血糖和自我报告确认T2DM的诊断。采用二元logistic回归模型和限制性立方样条模型评价OC的使用是否与T2DM相关。

结果：在未校正模型中, OC使用者T2DM危险度优势比（OR）为0.71（95%CI: 0.57-0.89）。在完全校正模型中, 相关性仍然显著, OR为0.78（95%CI: 0.62-0.99）。在分层分析中, 当女性超重时, OC使用与T2DM风险呈负相关。量效关系分析也显示OC使用时间与T2DM之间呈负非线性关系（线性的p值为0.589）。

结论：我们的研究结果提示OC的使用可能与T2DM风险呈负相关。

Keywords:

• oral contraceptive
• use duration
• type 2 diabetes mellitus
• dose-response
• NHANES

Acknowledgments

We thank all the staff at the CDC National Center for Health Statistics who designed, conducted and administered the NHANES surveys and all the members who participated in the NHANES study. We acknowledge professor Dongfeng Zhang for his help in conceiving and designing this study. We thank Luo Jia and senior Xue Dong for their help in data processing. We would also like to thank professor Dongfeng Zhang, senior Xue Dong, and senior Xiaohui Yu for their help in revising the article. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Ethical approval

NHANES was approved by the National Center for Health Statistics Research Ethics Review Board and had the informed consent of all participants. The detailed information of NHANES was shown at https://www.cdc.gov/nchs/nhanes/index.htm.

Author contributions

All authors have contributed to the work: Wenqin Yao and Dongfeng Zhang conceived and designed the study; Wenqin Yao, Xue Dong and Jia Luo analyzed the data; Wenqin Yao wrote the paper; Wenqin Yao, Xue Dong and Xiaohui Yu revised the paper. Dongfeng Zhang reviewed the manuscript and had primary responsibility for the final content.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data extracted was obtained from the National Health and Nutrition Examination Survey (NHANES). The detailed information of NHANES was shown at https://www.cdc.gov/nchs/nhanes/index.htm.