Background This study assessed the association of the hypertriglyceridemic waist (HTGW) phenotype with prediabetes and diabetes (DM) in a group of Hispanics. Methods Analysis of a cross-sectional study of 858 adults residing in Puerto Rico that collected data on blood pressure, biochemical, and anthropometric measurements was performed. HTGW phenotype was defined as elevated triglycerides and elevated waist circumference. Prediabetes was defined as a fasting glucose of 100–125 mg/dL and DM as a fasting glucose ≥126 mg/dL or prior diagnosis. Results Prevalence of HTGW, prediabetes and DM was 27.9%, 38.0% and 21.6%, respectively. Subjects with the HTGW phenotype had higher adjusted odds of prediabetes (POR=5.55; 95% CI=3.38–9.13) and DM (POR=7.28; 95% CI=3.63–14.63) compared to those without the phenotype. The association for prediabetes was stronger for women than among men. Discussion HTGW phenotype was strongly associated with prediabetes and DM, reinforcing the need to further assess its performance as a screening tool to identify at-risk individuals for cardiometabolic conditions.

OBJECTIVE Gestational diabetes mellitus complicates ∼6% of pregnancies and strongly predicts subsequent type 2 diabetes. It has not been fully elucidated how risk depends on the number of affected pregnancies or how long the excess risk persists. RESEARCH DESIGN AND METHODS We assessed reproductive histories in relation to risk of type 2 diabetes using a nationwide cohort of 50,884 women. Among participants who initially did not have diabetes, 3,370 were diagnosed with diabetes during 10 years of follow-up. We used Cox proportional hazards models that allowed risk to depend on age, cumulative number of pregnancies with gestational diabetes mellitus, and time since the most recent affected pregnancy, adjusting for BMI, educational level, and race/ethnicity. RESULTS History of one or more pregnancies with gestational diabetes mellitus predicted elevated age-specific risk of type 2 diabetes, with a hazard ratio of 3.87 (95% CI 2.60–5.75) 6–15 years after an affected pregnancy. Risk increased steeply with multiple affected pregnancies. The age-specific associations attenuated over time after an affected pregnancy, with an estimated 24% reduction of the hazard ratio per decade. Risk remained elevated, however, for >35 years. CONCLUSIONS Gestational diabetes mellitus predicted markedly increased rates of type 2 diabetes. Relative risk increased substantially with each additional affected pregnancy. The estimated hazard ratio declined with time after a pregnancy with gestational diabetes mellitus but remained elevated for >35 years. Women recalling a history of gestational diabetes mellitus should be screened regularly for type 2 diabetes, even late in life.

Background: Preeclampsia and gestational hypertension are hypothesized to be associated with reduced maternal breast cancer risk, but the epidemiologic evidence is inconclusive. Our objective was to examine associations between gestational hypertensive disorders and breast cancer in a nationwide cohort of women with a family history of breast cancer. Methods: Women ages 35-74 years who had a sister previously diagnosed with breast cancer, but had never had breast cancer themselves, were enrolled in the Sister Study from 2003 to 2009 (N = 50,884). At enrollment, participants reported diagnoses of eclampsia, preeclampsia, or gestational hypertension in each pregnancy. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between history of a gestational hypertensive disorder and incident invasive breast cancer or ductal carcinoma in situ among 40,720 parous women. We used age as the time scale and adjusted for birth cohort, race-ethnicity, and reproductive, socioeconomic, and behavioral factors. We examined effect measure modification by risk factors for gestational hypertensive disease and breast cancer and assessed possible etiologic heterogeneity across tumor characteristics. Results:The prevalence of gestational hypertensive disease was 12%. During follow-up (mean = 10.9 years), 3,198 eligible women self-reported a breast cancer diagnosis. History of a gestational hypertensive disorder was not associated with breast cancer risk (HR = 1.0; 95% CI = 0.90, 1.1). We did not observe clear evidence of effect measure modification or etiologic heterogeneity. Conclusions: History of a gestational hypertensive disorder was not associated with breast cancer risk in a cohort of women with a firstdegree family history of breast cancer.

Background Vitamin D may protect against breast cancer. Although Black/African American women and Hispanic/Latina women have lower circulating vitamin D levels than non‐Hispanic White women, few studies have examined the association between vitamin D and breast cancer within these racial/ethnic groups. Methods The vitamin D–breast cancer association was evaluated using a case‐cohort sample of self‐identified Black/African American and non‐Black Hispanic/Latina women participating in the US‐wide Sister Study cohort. Circulating 25‐hydroxyvitamin D (25(OH)D) and 24,25‐dihydroxyvitamin D (24,25(OH)2D) were measured using liquid chromatography‐tandem mass spectrometry in blood samples collected at the baseline from 415 women (290 Black/African American women and 125 non‐Black Hispanic/Latina women) who developed breast cancer. These were compared to concentrations in 1545 women (1084 Black/African American women and 461 Hispanic/Latina women) randomly selected from the cohort. Multivariable‐adjusted Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results Over a mean follow‐up of 9.2 years, women with circulating 25(OH)D concentrations above the clinical cut point for deficiency (20.0 ng/mL) had lower breast cancer rates than women with concentrations ≤ 20 ng/mL (HR, 0.79; 95% CI, 0.61‐1.02). The inverse association was strongest among Hispanic/Latina women (HR, 0.52; 95% CI, 0.29‐0.93), with a weaker association observed among Black/African American women (HR, 0.89; 95% CI, 0.68‐1.18; P for heterogeneity = 0.13). There were no clear differences by menopausal status, follow‐up time, estrogen receptor status, or invasiveness. Neither 24,25(OH)2D nor the 24,25(OH)2D to 25(OH)D ratio were independently associated with breast cancer risk. Conclusions This prospective study supports the hypothesis that vitamin D may be protective against breast cancer incidence in women, including non‐Black Hispanic/Latina and Black/African American women. LAY SUMMARY Vitamin D may protect against breast cancer. Although women of color have lower average vitamin D levels than non‐Hispanic White women, few studies have considered the role of race/ethnicity. In a sample of self‐identified Black/African American and Hispanic/Latina women, we observed that vitamin D concentrations measured in blood were inversely associated with breast cancer, particularly among Latinas. These findings indicate that vitamin D may protect women against breast cancer, including those in racial/ethnic groups with low average circulating levels.