Departments of Obstetrics and Gynecology Radiology, Oulu University Hospital, PO Box 23, FIN-90029 OYS Oulu, Finland.
Eur J Endocrinol. 2013 Oct 1;169(5):605-11. doi: 10.1530/EJE-13-0412. Print 2013 Nov.
Gestational diabetes mellitus (GDM) is associated with an increased risk of subsequent diabetes and metabolic syndrome (MS). The independent significance of overweight, often associated with GDM, is controversial. This study was aimed to investigate the prevalence of MS and carotid intima-media thickness (CIMT) values in normal and overweight women with previous insulin-treated GDM and control without GDM 19 years after the index pregnancy.
The study group consisted of 61 women with prior GDM and 55 controls who gave birth in Oulu University Hospital between 1988 and 1993. These women were further divided into subgroups according to pre-pregnancy BMI (<25 or ≥25 kg/m(2)). In 2008-2010, anthropometrics and blood pressure were measured, blood samples were taken, and an oral glucose tolerance test was performed to investigate the components of MS. CIMT was measured by Doppler ultrasound.
Total prevalence of MS was 62% in the GDM group and 31% in the control group (P=0.001); it was highest (86%) in GDM women with pre-pregnancy overweight. CIMT was significantly thicker (0.67 vs 0.56 mm, P=0.007) and more often abnormal (71.7 vs 45.3%, P=0.004) in the GDM group compared with the controls. In logistic regression analysis, the strongest factor predicting MS in the whole study population was pre-pregnancy overweight.
Pre-pregnancy overweight was the strongest predictive factor for later MS, whereas GDM indicated increased risk of subsequent diabetes and subclinical atherosclerosis. The risk of MS was highest when both of these factors were present.
妊娠糖尿病（GDM）与随后发生糖尿病和代谢综合征（MS）的风险增加有关。常与 GDM 相关的超重的独立意义存在争议。本研究旨在调查 19 年前经胰岛素治疗的 GDM 及无 GDM 的正常和超重妇女中 MS 的患病率和颈动脉内膜中层厚度（CIMT）值。
研究组包括 61 名曾患有 GDM 的妇女和 55 名对照组妇女，她们均于 1988 年至 1993 年在奥卢大学医院分娩。这些妇女根据孕前 BMI（<25 或≥25kg/m2）进一步分为亚组。2008-2010 年，测量了人体测量学和血压，采集了血样，并进行了口服葡萄糖耐量试验以调查 MS 的成分。通过多普勒超声测量 CIMT。
GDM 组的 MS 总患病率为 62%，对照组为 31%（P=0.001）；在患有孕前超重的 GDM 妇女中患病率最高（86%）。与对照组相比，GDM 组的 CIMT 明显更厚（0.67 对 0.56mm，P=0.007）且更常异常（71.7%对 45.3%，P=0.004）。在逻辑回归分析中，整个研究人群中预测 MS 的最强因素是孕前超重。
孕前超重是预测后期 MS 的最强因素，而 GDM 则表明随后发生糖尿病和亚临床动脉粥样硬化的风险增加。当这两个因素同时存在时，MS 的风险最高。
