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Sex ratio at birth is associated with type 1 diabetes characteristics

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Abstract

Aims

To assess the association between maternal diabetes characteristics and sex ratio at birth (SRB) in women with type 1 diabetes mellitus.

Methods

We performed a case–control study. The study subjects were infants born alive to women with type 1 diabetes and singleton pregnancies. Cases and controls were defined as male and female newborns, respectively. SRB was analysed according to diabetes-related characteristics adjusting in a logistic regression analysis for maternal characteristics known to affect SRB in the general population.

Results

The observed SRB (238 males/468 live births = 0.509) did not differ from the expected. In the logistic regression analysis, SRB was significantly associated with three diabetes characteristics: (1) diabetes duration, with odds ratios (ORs) for a live male newborn = 1.22 (95 % confidence interval (CI), 0.66–2.24 for ≤5 years, OR 2.79 (95 % CI 1.36–5.74) for >20 years; (2) mean first-trimester glycated haemoglobin, with OR 1.98 (95 % CI 1.09–3.62) for ≤6.7 % (50 mmol/mol) and OR 2.61 (95 % CI 1.16–5.85) for >8.2 % (66 mmol/mol) and (3) mean first-trimester insulin dose, with OR 0.70 (95 % CI 0.36–1.38) for ≤0.5 IU/kg/day and OR 0.18 (95 % CI 0.05–0.59) for >1.0 IU/kg/day.

Conclusions

We conclude that SRB in this cohort is independently associated with three diabetes characteristics. These associations are to be confirmed.

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References

  1. Davis DL, Gottlieb MB, Stampnitzky JR (1998) Reduced ratio of male to female births in several industrial countries: a sentinel health indicator? JAMA 279:1018–1023

    Article  CAS  PubMed  Google Scholar 

  2. Trivers RL, Willard DE (1973) Natural selection of parental ability to vary the sex ratio of offspring. Science 179:90–92

    Article  CAS  PubMed  Google Scholar 

  3. James WH (2012) The relevance of the epidemiology of human sex ratios at birth to some medical problems. Paediatr Perinat Epidemiol 26:181–189

    Article  PubMed  Google Scholar 

  4. James WH (1996) Interpregnancy intervals, high maternal age and seasonal effects on the human sex ratio. Hum Reprod 11:7–8

    Article  CAS  PubMed  Google Scholar 

  5. Lyster WR (1974) Altered sex ratio after the London smog of 1952 and the Brisbane flood of 1965. J Obstet Gynaecol Br Commonw 81:626–631

    Article  CAS  PubMed  Google Scholar 

  6. Catalano R, Bruckner T, Gould J, Eskenazi B, Anderson E (2005) Sex ratios in California following the terrorist attacks of September 11, 2001. Hum Reprod 20:1221–1227

    Article  PubMed  Google Scholar 

  7. Juntunen KS, Kvist AP, Kauppila AJ (1997) A shift from a male to a female majority in newborns with the increasing age of grand grand multiparous women. Hum Reprod 12:2321–2323

    Article  CAS  PubMed  Google Scholar 

  8. Erickson JD (1976) The secondary sex ratio in the United States 1969-71: association with race, parental ages, birth order, paternal education and legitimacy. Ann Hum Genet 40:205–212

    Article  CAS  PubMed  Google Scholar 

  9. Fukuda M, Fukuda K, Shimizu T, Andersen CY, Byskov AG (2002) Parental periconceptional smoking and male: female ratio of newborn infants. Lancet 359:1407–1408

    Article  PubMed  Google Scholar 

  10. Cagnacci A, Renzi A, Arangino S, Alessandrini C, Volpe A (2004) Influences of maternal weight on the secondary sex ratio of human offspring. Hum Reprod 19:442–444

    Article  CAS  PubMed  Google Scholar 

  11. Kanazawa S (2005) Big and tall parents have more sons: further generalizations of the Trivers-Willard hypothesis. J Theor Biol 235:583–590

    Article  PubMed  Google Scholar 

  12. Grech V, Vassallo-Agius P, Savona-Ventura C (2000) Declining male births with increasing geographical latitude in Europe. J Epidemiol Community Health 54:244–246

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Chason RJ, McLain AC, Sundaram R et al (2012) Preconception stress and the secondary sex ratio: a prospective cohort study. Fertil Steril 98:937–941. doi:10.1016/j.fertnstert.2012.06.037

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lei JH, Yang X, Peng S et al (2015) Impact of corticosteroid-binding globulin deficiency on pregnancy and neonatal sex. J Clin Endocrinol Metab 100:1819–1827. doi:10.1210/jc.2014-4254

    Article  CAS  PubMed  Google Scholar 

  15. Noorlander AM, Geraedts JPM, Melissen JBM (2010) Female gender pre-selection by maternal diet in combination with timing of sexual intercourse–a prospective study. Reprod Biomed Online 21:794–802. doi:10.1016/j.rbmo.2010.08.002

    Article  CAS  PubMed  Google Scholar 

  16. Mathews F, Johnson PJ, Neil A (2008) You are what your mother eats: evidence for maternal preconception diet influencing foetal sex in humans. Proc Biol Sci 275:1661–1668. doi:10.1098/rspb.2008.0105

    Article  PubMed  PubMed Central  Google Scholar 

  17. Bae J, Kim S, Kannan K, Buck Louis GM (2015) Couples’ urinary bisphenol A and phthalate metabolite concentrations and the secondary sex ratio. Environ Res 137:450–457. doi:10.1016/j.envres.2014.11.011

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Hagenfeldt K, Janson PO, Holmdahl G et al (2008) Fertility and pregnancy outcome in women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Hum Reprod 23:1607–1613. doi:10.1093/humrep/den118

    Article  CAS  PubMed  Google Scholar 

  19. Miñambres DI, Ovejero Crespo D, García-Paterson A, Adelantado JM, Corcoy Pla R (2013) Sex ratio at birth is associated with first-trimester maternal thyrotropin in women receiving levothyroxine. Thyroid 23:1514–1517. doi:10.1089/thy.2012.0530

    Article  CAS  PubMed  Google Scholar 

  20. Rjasanowski I, Klöting I, Kovacs P (1998) Altered sex ratio in offspring of mothers with insulin-dependent diabetes mellitus. Lancet 351:497–498

    Article  CAS  PubMed  Google Scholar 

  21. Møller H, Jacobsen R, Tjønneland A, Overvad K (1998) Sex ratio of offspring of diabetics. Lancet 351:1514–1515

    Article  PubMed  Google Scholar 

  22. Casson IF, Clarke CA, Howard CV et al (1997) Outcomes of pregnancy in insulin dependent diabetic women: results of a five year population cohort study. BMJ 315:275–278

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Paterson AD (1998) Sex ratio of offspring of diabetics. Lancet 351:1515

    Article  CAS  PubMed  Google Scholar 

  24. Manderson JG, Mullan B, Patterson CC, Hadden DR, Traub AI, McCance DR (2002) Cardiovascular and metabolic abnormalities in the offspring of diabetic pregnancy. Diabetologia 45:991–996

    Article  CAS  PubMed  Google Scholar 

  25. Cypryk K, Pertynska-Marczewska M, Wender-Ozegowska E, Lewinski A (2007) The sex ratios of offspring of diabetic parents. Diabet Med 24:925–926 (author reply 926)

    Article  CAS  PubMed  Google Scholar 

  26. Ehrlich SF, Eskenazi B, Hedderson MM, Ferrara A (2012) Sex ratio variations among the offspring of women with diabetes in pregnancy. Diabet Med 29:e273–e278. doi:10.1111/j.1464-5491.2012.03663.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Holstein A, Patzer O, Tiemann T, Vortherms J, Kovacs P (2012) Number and sex ratio of children and impact of parental diabetes in individuals with Type 1 diabetes. Diabet Med 29:1268–1271. doi:10.1111/j.1464-5491.2012.03618.x

    Article  CAS  PubMed  Google Scholar 

  28. James WH (2006) The sex ratios of offspring of diabetic parents. Diabet Med 23:1043–1044

    Article  CAS  PubMed  Google Scholar 

  29. Cameron EZ (2004) Facultative adjustment of mammalian sex ratios in support of the Trivers-Willard hypothesis: evidence for a mechanism. Proc Biol Sci 271:1723–1728

    Article  PubMed  PubMed Central  Google Scholar 

  30. The DCCT Research Group (1987) Feasibility of centralized measurements of glycated hemoglobin in the Diabetes Control and Complications Trial: a multicenter study. Clin Chem 33:2267–2271

    Google Scholar 

  31. Jiménez A, Madrid-Bury N, Fernández R et al (2003) Hyperglycemia-induced apoptosis affects sex ratio of bovine and murine preimplantation embryos. Mol Reprod Dev 65:180–187

    Article  CAS  PubMed  Google Scholar 

  32. Savona-Ventura S, Savona-Ventura C (2013) Factors determining gender ratio in the Maltese population. Malta Med J 25:19–24

    Google Scholar 

  33. Machado AF, Zimmerman EF, Hovland DN, Weiss R, Collins MD (2001) Diabetic embryopathy in C57BL/6 J mice. Altered fetal sex ratio and impact of the splotch allele. Diabetes 50:1193–1199

    Article  CAS  PubMed  Google Scholar 

  34. Zhu J, Zhuang X, Chen L, Liu P, Qiao J (2015) Effect of embryo culture media on percentage of males at birth. Hum Reprod 30:1039–1045. doi:10.1093/humrep/dev049

    Article  PubMed  Google Scholar 

  35. Rosenfeld CS, Roberts RM (2004) Maternal diet and other factors affecting offspring sex ratio: a review. Biol Reprod 71:1063–1070

    Article  CAS  PubMed  Google Scholar 

  36. Zhu P, Tong SL, Hao JH et al (2015) Cord blood vitamin D and neurocognitive development are nonlinearly related in toddlers. J Nutr 145:1232–1238. doi:10.3945/jn.114.208801

    Article  CAS  PubMed  Google Scholar 

  37. Shah DK, Missmer SA, Berry KF, Racowsky C, Ginsburg ES (2011) Effect of obesity on oocyte and embryo quality in women undergoing in vitro fertilization. Obstet Gynecol 118:63–70. doi:10.1097/AOG.0b013e31821fd360

    Article  PubMed  Google Scholar 

  38. Sharashova EE, Anda EE, Grjibovski AM (2014) Early pregnancy body mass index and spontaneous preterm birth in Northwest Russia: a registry-based study. BMC Pregnancy Childbirth 14:303. doi:10.1186/1471-2393-14-303

    Article  PubMed  PubMed Central  Google Scholar 

  39. James WH (2010) Inconstancy of human sex ratios at birth. Fertil Steril 94:e53. doi:10.1016/j.fertnstert.2010.05.044 (author reply e54)

    Article  PubMed  Google Scholar 

  40. Lowe CR, McKeown T (1950) The sex ratio of human births related to maternal age. Br J Soc Med 4:75–85

    PubMed Central  Google Scholar 

  41. Rueness J, Vatten L, Eskild A (2012) The human sex ratio: effects of maternal age. Hum Reprod 27:283–287. doi:10.1093/humrep/der347

    Article  PubMed  Google Scholar 

  42. Arcand JL, Rieger M (2012) Maternal height and the sex ratio. http://graduateinstitute.ch/files/live/sites/iheid/files/sites/international_economics/shared/international_economics/prof_websites/arcand/publications/JEP_R_R_21April12_final.pdf. Accessed 24 Sept 2016

  43. Kautzky-Willer A, Kosi L, Lin J, Mihaljevic R (2015) Gender-based differences in glycaemic control and hypoglycaemia prevalence in patients with type 2 diabetes: results from patient-level pooled data of six randomized controlled trials. Diabetes Obes Metab 17:533–540. doi:10.1111/dom.12449

    Article  CAS  PubMed  Google Scholar 

  44. Arnetz L, Dorkhan M, Alvarsson M, Brismar K, Ekberg NR (2014) Gender differences in non-glycemic responses to improved insulin sensitivity by pioglitazone treatment in patients with type 2 diabetes. Acta Diabetol 51:185–192. doi:10.1007/s00592-013-0457-y

    Article  CAS  PubMed  Google Scholar 

  45. Di Renzo GC, Rosati A, Sarti RD, Cruciani L, Cutuli AM (2007) Does fetal sex affect pregnancy outcome? Gend Med 4:19–30

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Carolyn Newey for language assistance.

Author contributions

Dr. R. C. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. A. G. P. and R. C. designed and conducted the study, performed data collection and analysis and wrote the manuscript. I. M. contributed to design, data collection and analysis of this manuscript. J. M. A. contributed to data collection and analysis of this manuscript. I. G., T. P. and A. L. contributed to design and analysis of this manuscript.

Author information

Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Avgda. Sant Antoni Mª Claret 167, 08025, Barcelona, Spain

    Apolonia García-Patterson, Inka Miñambres, Alberto de Leiva & Rosa Corcoy

  2. Department of Gynecology and Obstetrics, Hospital de la Santa Creu i Sant Pau, Avgda. Sant Antoni Mª Claret 167, 08025, Barcelona, Spain

    Juan María Adelantado

  3. Department of Pediatrics, Obstetrics and Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Plaça Cívica, Campus de la UAB, 08193, Cerdanyola, Spain

    Juan María Adelantado & Teresa Puig

  4. Department of Clinic Epidemiology and Public Health, Hospital de la Santa Creu i Sant Pau, Avgda. Sant Antoni Mª Claret 167, 08025, Barcelona, Spain

    Ignasi Gich & Teresa Puig

  5. Department of Clinical Pharmacology and Therapeutics, Universitat Autònoma de Barcelona, Plaça Cívica, Campus de la UAB, 08193, Cerdanyola, Spain

    Ignasi Gich

  6. CIBER Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Av. de Monforte de Lemos, 5, 28029, Madrid, Spain

    Ignasi Gich

  7. Institute of Biomedical Research (IIB Sant Pau), Hospital de la Santa Creu i Sant Pau, Avgda. Sant Antoni Mª Claret 167, 08025, Barcelona, Spain

    Ignasi Gich, Teresa Puig, Alberto de Leiva & Rosa Corcoy

  8. Department of Medicine, Universitat Autònoma de Barcelona, Plaça Cívica, Campus de la UAB, 08193, Cerdanyola, Spain

    Alberto de Leiva & Rosa Corcoy

  9. CIBER Bioengineering, Biomaterials and Nanotechnology (CIBER-BBN), Instituto de Salud Carlos III, c/Poeta Mariano Esquillor s/n, 50018, Zaragoza, Spain

    Alberto de Leiva & Rosa Corcoy

Authors
  1. Apolonia García-Patterson
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  2. Inka Miñambres
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  3. Juan María Adelantado
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  4. Ignasi Gich
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  5. Teresa Puig
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  6. Alberto de Leiva
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  7. Rosa Corcoy
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Corresponding author

Correspondence to Rosa Corcoy.

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Conflict of interest

Apolonia García-Patterson, Inka Miñambres, Juan María Adelantado, Ignasi Gich, Teresa Puig, Alberto de Leiva and Rosa Corcoy declare that they have no conflict of interest.

Human and animal rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

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The institutional review board that waived the obtainment of informed consent approved the study.

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García-Patterson, A., Miñambres, I., Adelantado, J.M. et al. Sex ratio at birth is associated with type 1 diabetes characteristics. Acta Diabetol 53, 1025–1035 (2016). https://doi.org/10.1007/s00592-016-0919-0

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