Departments of Medicine and Obstetrics and Gynecology, University of Michigan, 2800 Plymouth Road, Building 16, Room 430W, Ann Arbor, MI, 48109-2800, USA,
Matern Child Health J. 2014 Apr;18(3):698-706. doi: 10.1007/s10995-013-1295-9.
Based on their higher risk of type 2 diabetes, non-Hispanic blacks (NHBs) would be expected to have higher gestational diabetes mellitus (GDM) risk compared to non-Hispanic whites (NHWs). However, previous studies have reported lower GDM risk in NHBs versus NHWs. We examined whether GDM risk was lower in NHBs and NHWs, and whether this disparity differed by age group. The cohort consisted of 462,296 live singleton births linked by birth certificate and hospital discharge data from 2004 to 2007 in Florida. Using multivariable regression models, we examined GDM risk stratified by age and adjusted for body mass index (BMI) and other covariates. Overall, NHBs had a lower prevalence of GDM (2.5 vs. 3.1%, p < 0.01) and a higher proportion of preconception DM births (0.5 vs. 0.3%, p ≤ 0.01) than NHWs. Among women in their teens (risk ratio 0.56, p < 0.01) and 20-29 years of age (risk ratio 0.85, p < 0.01), GDM risk was lower in NHBs than NHWs. These patterns did not change with adjustment for BMI and other covariates. Among women 30-39 years (risk ratio 1.18, p < 0.01) and ≥40 years (risk ratio 1.22, p < 0.01), GDM risk was higher in NHBs than NHWs, but risk was higher in NHWs after adjustment for BMI. Associations between BMI and GDM risk did not vary by race/ethnicity or age group. NHBs have lower risk of GDM than NHWs at younger ages, regardless of BMI. NHBs had higher risk than NHWs at older ages, largely due to racial/ethnic disparities in overweight/obesity at older ages.
基于非西班牙裔黑种人（NHB）患 2 型糖尿病的风险较高，预计他们患妊娠糖尿病（GDM）的风险会高于非西班牙裔白种人（NHW）。然而，先前的研究报告称 NHB 患 GDM 的风险低于 NHW。我们研究了 NHB 和 NHW 患 GDM 的风险是否更低，以及这种差异是否因年龄组而异。该队列由 2004 年至 2007 年佛罗里达州的出生证明和医院出院数据链接的 462296 名活产单胎组成。我们使用多变量回归模型，根据年龄分层检查了 GDM 风险，并根据体重指数（BMI）和其他协变量进行了调整。总体而言，NHB 的 GDM 患病率较低（2.5%比 3.1%，p<0.01），且孕前糖尿病出生比例较高（0.5%比 0.3%，p≤0.01）。在十几岁（风险比 0.56，p<0.01）和 20-29 岁的女性中，NHB 的 GDM 风险低于 NHW。这些模式在调整 BMI 和其他协变量后并未改变。在 30-39 岁（风险比 1.18，p<0.01）和≥40 岁的女性中（风险比 1.22，p<0.01），NHB 的 GDM 风险高于 NHW，但在调整 BMI 后，NHW 的风险更高。BMI 和 GDM 风险之间的关联不因种族/民族或年龄组而异。无论 BMI 如何，NHB 在较年轻的年龄组中 GDM 的风险均低于 NHW。NHB 在年龄较大的年龄组中风险高于 NHW，主要是由于年龄较大的超重/肥胖人群中存在种族/民族差异。
