Dabelea Dana, Snell-Bergeon Janet K, Hartsfield Cynthia L, Bischoff Kimberly J, Hamman Richard F, McDuffie Robert S
Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO, USA.
Diabetes Care. 2005 Mar;28(3):579-84. doi: 10.2337/diacare.28.3.579.
The prevalence of gestational diabetes mellitus (GDM) varies in direct proportion with the prevalence of type 2 diabetes in a given population or ethnic group. Given that the number of people with diabetes worldwide is expected to increase at record levels through 2030, we examined temporal trends in GDM among diverse ethnic groups.
Kaiser Permanente of Colorado (KPCO) has used a standard protocol to universally screen for GDM since 1994. This report is based on 36,403 KPCO singleton pregnancies occurring between 1994 and 2002 and examines trends in GDM prevalence among women with diverse ethnic backgrounds.
The prevalence of GDM among KPCO members doubled from 1994 to 2002 (2.1-4.1%, P < 0.001), with significant increases in all racial/ethnic groups. In logistic regression, year of diagnosis (odds ratio [OR] and 95% CI per 1 year = 1.12 [1.09-1.14]), mother's age (OR per 5 years = 1.7 [1.6-1.8]) and ethnicity other than non-Hispanic white (OR = 2.1 [1.9-2.4]) were all significantly associated with GDM. Birth year remained significant (OR = 1.06, P = 0.006), even after adjusting for prior GDM history.
This study shows that the prevalence of GDM is increasing in a universally screened multiethnic population. The increasing GDM prevalence suggests that the vicious cycle of diabetes in pregnancy initially described among Pima Indians may also be occurring among other U.S. ethnic groups.
妊娠期糖尿病（GDM）的患病率与特定人群或种族中2型糖尿病的患病率成正比。鉴于预计到2030年全球糖尿病患者数量将创纪录地增加，我们研究了不同种族群体中GDM的时间趋势。
自1994年以来，科罗拉多州凯撒医疗机构（KPCO）一直采用标准方案对GDM进行普遍筛查。本报告基于1994年至2002年间KPCO的36403例单胎妊娠，研究了不同种族背景女性中GDM患病率的趋势。
1994年至2002年间，KPCO成员中GDM的患病率翻了一番（从2.1%升至4.1%，P<0.001），所有种族/族裔群体均显著增加。在逻辑回归分析中，诊断年份（每1年的比值比[OR]及95%置信区间=1.12[1.09 - 1.14]）、母亲年龄（每5岁的OR = 1.7[1.6 - 1.8]）以及非西班牙裔白人以外的种族（OR = 2.1[1.9 - 2.4]）均与GDM显著相关。即使在调整了既往GDM病史后，出生年份仍具有显著性（OR = 1.06，P = 0.006）。
本研究表明，在进行普遍筛查的多民族人群中，GDM的患病率正在上升。GDM患病率的上升表明，最初在皮马印第安人当中描述的妊娠糖尿病恶性循环可能也在美国其他种族群体中出现。
