Department of Obstetrics and Gynecology, Soroka University Medical Center, POB 151, Beer Sheva 84101, Israel.
Heart. 2013 Aug;99(15):1118-21. doi: 10.1136/heartjnl-2013-303945. Epub 2013 Jun 8.
To investigate whether a diagnosis of gestational diabetes mellitus (GDM) is a risk factor for subsequent long-term cardiovascular morbidity.
A population-based study.
Soroka University Medical Center, a tertiary centre in the southern region of Israel.
A cohort of women with and without a diagnosis of GDM who delivered during the years 1988-1999 with a follow-up period until 2010.
A comparison of the incidence of cardiovascular morbidity.
Of 47 909 deliveries that met the inclusion criteria, 4928 (10.3%) occurred in patients who were diagnosed with GDM. During a follow-up period of more than 10 years, compared with women who gave birth at the same time period, after adjustment for age and ethnicity, patients with GDM had higher rates of cardiovascular morbidity including non-invasive cardiac diagnostic procedures (OR=1.8; 95% CI 1.4 to 2.2), simple cardiovascular events (OR=2.7; 95% CI 2.4 to 3.1) and total cardiovascular hospitalisations (OR=2.3; 95% CI 2.0 to 2.5). In a Cox proportional hazards model, adjusted for comorbidities such as pre-eclampsia and obesity, GDM was independently associated with cardiovascular hospitalisations (adjusted HR 2.6, 95% CI 2.3 to 3).
GDM is an independent risk factor for long-term cardiovascular morbidity in a follow-up period of more than a decade.
探讨妊娠期糖尿病（GDM）的诊断是否是随后发生长期心血管疾病的风险因素。
基于人群的研究。
以色列南部地区的索罗卡大学医学中心，一所三级中心。
1988 年至 1999 年间分娩的、有或无 GDM 诊断的患者队列，随访期直至 2010 年。
心血管疾病发病率的比较。
符合纳入标准的 47909 次分娩中，有 4928 次（10.3%）发生在被诊断为 GDM 的患者中。在超过 10 年的随访期间，与在同一时期分娩的女性相比，校正年龄和种族后，患有 GDM 的患者发生心血管疾病的风险更高，包括非侵入性心脏诊断程序（OR=1.8；95%CI 1.4 至 2.2）、单纯心血管事件（OR=2.7；95%CI 2.4 至 3.1）和心血管疾病总住院（OR=2.3；95%CI 2.0 至 2.5）。在 Cox 比例风险模型中，校正子痫前期和肥胖等合并症后，GDM 与心血管疾病住院（调整 HR 2.6，95%CI 2.3 至 3）独立相关。
在超过 10 年的随访期间，GDM 是长期心血管疾病发病的独立风险因素。
