Lauenborg Jeannet, Mathiesen Elisabeth, Hansen Torben, Glümer Charlotte, Jørgensen Torben, Borch-Johnsen Knut, Hornnes Peter, Pedersen Oluf, Damm Peter
Department of Obstetrics, 4031, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark.
J Clin Endocrinol Metab. 2005 Jul;90(7):4004-10. doi: 10.1210/jc.2004-1713. Epub 2005 Apr 19.
Diabetes and obesity, components of the metabolic syndrome, are common characteristics of women with prior gestational diabetes mellitus (GDM). Due to increasing incidence of diabetes and obesity, the metabolic syndrome might comprise a major health problem among these women.
The objective was to estimate the prevalence of the metabolic syndrome by three different criteria [World Health Organization 1999 (WHO), The National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults 2001, and European Group for the Study of Insulin Resistance 2002] among women with previous GDM.
We conducted a follow-up study of a Danish cohort of women admitted in 1978-1996 to the Diabetes and Pregnancy Center, Rigshospitalet, Copenhagen University Hospital, with diet-treated GDM. The follow-up took place in 2000-2002 at median 9.8 yr (interquartile range 6.4-17.2) after pregnancy. Results were compared with a control group of 1000 age-matched women from a population-based sample (Inter99).
Four hundred eighty-one women at median age 43 yr (interquartile range 38-48) participated.
The main outcome measures were body mass index (BMI), glucose tolerance, blood pressure, lipid profile, and insulin resistance.
Independent of the criteria, the prevalence of the metabolic syndrome was three times higher in the prior GDM group, compared with the control group (e.g. WHO: 38.4 vs. 13.4%, P < 0.0005). Age- and BMI-adjusted odds ratio for having the WHO-defined metabolic syndrome was 3.4 (95% confidence interval 2.5-4.8) for the prior GDM group vs. the control group. Obese women (BMI > 30 kg/m(2)) with previous GDM had a more than 7-fold increased prevalence of the metabolic syndrome (WHO), compared with normal-weight prior GDM women (BMI < 25 kg/m(2)). In glucose-tolerant women, the prevalence was doubled in the prior GDM group, compared with control group.
The prevalence of the metabolic syndrome was three times as high in women with prior diet-treated GDM, compared with age-matched control subjects.
糖尿病和肥胖是代谢综合征的组成部分，是既往患有妊娠期糖尿病（GDM）女性的常见特征。由于糖尿病和肥胖的发病率不断上升，代谢综合征可能成为这些女性的一个主要健康问题。
目的是通过三种不同标准[世界卫生组织1999年（WHO）、美国国家胆固醇教育计划成人高胆固醇检测、评估和治疗专家小组2001年以及胰岛素抵抗研究欧洲小组2002年]估计既往患有GDM的女性中代谢综合征的患病率。
我们对丹麦一组于1978 - 1996年入住哥本哈根大学医院里格霍斯皮塔利特糖尿病与妊娠中心、接受饮食治疗的GDM女性进行了随访研究。随访于妊娠后中位数9.8年（四分位间距6.4 - 17.2年）的2000 - 2002年进行。将结果与来自基于人群样本（Inter99）的1000名年龄匹配女性的对照组进行比较。
481名女性参与，年龄中位数为43岁（四分位间距38 - 48岁）。
主要观察指标为体重指数（BMI）、糖耐量、血压、血脂谱和胰岛素抵抗。
无论采用何种标准，既往GDM组中代谢综合征的患病率是对照组的三倍（例如WHO标准：38.4%对13.4%，P < 0.0005）。既往GDM组与对照组相比，年龄和BMI调整后的患有WHO定义的代谢综合征的优势比为3.4（95%置信区间2.5 - 4.8）。与体重正常的既往GDM女性（BMI < 25 kg/m²）相比，既往患有GDM的肥胖女性（BMI > 30 kg/m²）代谢综合征的患病率增加了7倍多（WHO标准）。在糖耐量正常的女性中，既往GDM组的患病率是对照组的两倍。
与年龄匹配的对照受试者相比，既往接受饮食治疗的GDM女性中代谢综合征的患病率高三倍。
