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Mosorin M, Ollila M, Nordström T, Jokelainen J, Piltonen T, Auvinen J, Morin‐Papunen L, Tapanainen J. Former long-term use of combined hormonal contraception and glucose metabolism disorders in perimenopausal women: A prospective, population-based cohort study. Acta Obstet Gynecol Scand 2023; 102:1488-1495. [PMID: 37568273 PMCID: PMC10577621 DOI: 10.1111/aogs.14636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/13/2023] [Accepted: 06/26/2023] [Indexed: 08/13/2023]
Abstract
INTRODUCTION Current use of combined hormonal contraceptives worsens glucose tolerance and increases the risk of type 2 diabetes mellitus at late fertile age, but the impact of their former use on the risk of glucose metabolism disorders is still controversial. MATERIAL AND METHODS This was a prospective, longitudinal birth cohort study with long-term follow-up consisting of 5889 women. The cohort population has been followed at birth, and at ages of 1, 14, 31 and 46. In total, 3280 (55.7%) women were clinically examined and 2780 also underwent a 2-h oral glucose tolerance test at age 46. Glucose metabolism indices were analyzed in former combined hormonal contraceptive users (n = 1371) and former progestin-only contraceptive users (n = 52) and in women with no history of hormonal contraceptive use (n = 253). RESULTS Compared with women with no history of hormonal contraceptive use, those who formerly used combined hormonal contraceptives for over 10 years had an increased risk of prediabetes (odds ratio [OR] 3.9, 95% confidence interval [CI]: 1.6-9.2) but not of type 2 diabetes mellitus. Former progestin-only contraceptive use was not associated with any glucose metabolism disorders. The results persisted after adjusting for socioeconomic status, smoking, alcohol consumption, parity, body mass index and use of cholesterol-lowering medication. CONCLUSIONS Former long-term use of combined hormonal contraceptives was associated with a significantly increased risk of prediabetes in perimenopausal women, which potentially indicates a need of screening for glucose metabolism disorders in these women.
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Affiliation(s)
- Maria‐Elina Mosorin
- Department of Obstetrics and GynecologyOulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of OuluOuluFinland
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Research Unit of Clinical Medicine Oulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Meri‐Maija Ollila
- Department of Obstetrics and GynecologyOulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of OuluOuluFinland
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Research Unit of Clinical Medicine Oulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Tanja Nordström
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Center for Life Course Health ResearchUniversity of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Jari Jokelainen
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Terhi Piltonen
- Department of Obstetrics and GynecologyOulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of OuluOuluFinland
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Research Unit of Clinical Medicine Oulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Juha Auvinen
- Center for Life Course Health ResearchUniversity of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Unit of General PracticeOulu University Hospital, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Laure Morin‐Papunen
- Department of Obstetrics and GynecologyOulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of OuluOuluFinland
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Research Unit of Clinical Medicine Oulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
| | - Juha Tapanainen
- Department of Obstetrics and GynecologyOulu University Hospital, Wellbeing Services County of North Ostrobothnia, University of OuluOuluFinland
- Medical Research CenterOulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Research Unit of Clinical Medicine Oulu University Hospital, University of Oulu, Wellbeing Services County of North OstrobothniaOuluFinland
- Department of Obstetrics and GynecologyUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
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Bayartai ME, Määttä J, Karppinen J, Oura P, Takatalo J, Auvinen J, Raija K, Niemelä M, Luomajoki H. Association of accelerometer-measured physical activity, back static muscular endurance and abdominal obesity with radicular pain and non-specific low back pain. Sci Rep 2023; 13:7736. [PMID: 37173344 PMCID: PMC10181985 DOI: 10.1038/s41598-023-34733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/06/2023] [Indexed: 05/15/2023] Open
Abstract
Low back pain (LBP) is the leading cause of disability worldwide and often associated with lifestyle factors. However, studies further examining the role of these lifestyle factors in non-specific low back pain in comparison with radicular pain are sparse. The aim of this cross sectional study was to investigate how diverse lifestyle factors are associated with LBP. The study population of 3385 middle aged adults with and without low back pain was drawn from a large Birth 1966 Cohort. Outcome measures were steps per day, abdominal obesity, physical activity and endurance of the back muscles. Back static muscular endurance, abdominal obesity and physical activity were measured by means of the Biering-Sørensen test, waist circumference and a wrist worn accelerometer, respectively. Logistic regression analysis was applied to estimate associations of back static muscular endurance, abdominal obesity and accelerometer-measured physical activity with non-specific low back pain and radicular pain. An additional 1000 steps per day were associated with 4% lower odds of having non-specific low back pain. Participants with abdominal obesity had 46% higher odds of having radicular pain, whereas increases of 10 s in back static muscular endurance and 10 min in daily vigorous physical activity were associated with 5% and 7% lower odds of having radicular pain, respectively. In this population-based study, non-specific low back pain and radicular pain were associated with different lifestyle and physical factors at midlife. Non-specific low back pain was associated only with the average daily number of steps, whereas abdominal obesity was the strongest determinant of radicular pain, followed by vigorous physical activity and back static muscular endurance. The findings of this study contribute to better understand the role of lifestyle factors in both non-specific low back pain and radicular pain. Future longitudinal studies are required to explore causality.
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Affiliation(s)
- Munkh-Erdene Bayartai
- Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, ZHAW, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
- Department of Physical Therapy, School of Nursing, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
| | - Juhani Määttä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jaro Karppinen
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Petteri Oura
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Jani Takatalo
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Korpelainen Raija
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation Sr., Oulu, Finland
| | - Maisa Niemelä
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- Research Unit of Medical Imaging, Physics and Technology, University of Oulu, Oulu, Finland
- Research Unit of Health Sciences and Technology, University of Oulu, Oulu, Finland
| | - Hannu Luomajoki
- Institute of Physiotherapy, School of Health Professions, Zurich University of Applied Sciences, ZHAW, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland.
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