Brite J, Shiroma E J, Bowers K, Yeung E, Laughon S K, Grewal J G, Zhang C
Epidemiology Branch, Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD; School of Public Health, City University of New York, New York, NY.
Diabet Med. 2014 Mar;31(3):332-40. doi: 10.1111/dme.12355. Epub 2013 Dec 6.
Gestational diabetes is a common pregnancy complication affecting races/ethnicities disproportionally. Adult height, an indicator of both genetic and early-life factors, is inconsistently associated with gestational diabetes risk. We examined the association and whether it varies by races in a nationally representative US cohort.
Analyses were conducted among 135 861 pregnancies in the Consortium on Safe Labor, 5567 of which were diagnosed with gestational diabetes based on medical records review. Generalized estimating equations were used to estimate odds ratios (95% confidence intervals) of gestational diabetes, controlling for other risk factors including body weight. Additionally, a meta-analysis of 15 761 pregnancies with gestational diabetes and 205 828 without gestational diabetes was conducted to estimate the pooled mean difference in height between those with gestational diabetes and control subjects.
Height was inversely associated with gestational diabetes risk across races/ethnicities, with the strongest association among Asians (P for interaction < 0.01). Comparing extreme quartiles (> 168 vs. < 157 cm), adjusted odds ratios (95% confidence intervals) were 0.18 (0.09-0.36) for Asians/Pacific Islanders, 0.33 (0.29-0.38) for non-Hispanic white women, 0.39 (0.31-0.51) for Hispanics and 0.59 (0.47-0.75) for non-Hispanic black women. Meta-analysis found women with gestational diabetes to be significantly shorter than others.
Taller women are at lower risk of developing gestational diabetes, with the magnitude of association varying significantly across races/ethnicities.
妊娠期糖尿病是一种常见的妊娠并发症,不同种族/族裔受其影响的比例不均衡。成人身高是遗传和早期生活因素的一个指标,与妊娠期糖尿病风险的关联并不一致。我们在美国一个具有全国代表性的队列中研究了这种关联以及它是否因种族而异。
对安全分娩联盟中的135861例妊娠进行了分析,其中5567例根据病历审查被诊断为妊娠期糖尿病。使用广义估计方程来估计妊娠期糖尿病的比值比(95%置信区间),同时控制包括体重在内的其他风险因素。此外,对15761例患有妊娠期糖尿病的妊娠和205828例未患妊娠期糖尿病的妊娠进行了荟萃分析,以估计患有妊娠期糖尿病者与对照者之间身高的合并平均差异。
在所有种族/族裔中,身高与妊娠期糖尿病风险呈负相关,在亚洲人中这种关联最强(交互作用P<0.01)。比较身高的极端四分位数(>168 vs.<157厘米),亚洲/太平洋岛民的调整后比值比(95%置信区间)为0.18(0.09 - 0.36),非西班牙裔白人女性为0.33(0.29 - 0.38),西班牙裔为0.39(0.31 - (此处原文有误,应为0.51)0.51),非西班牙裔黑人女性为0.59(0.47 - 0.75)。荟萃分析发现患有妊娠期糖尿病的女性明显比其他人矮。
较高的女性患妊娠期糖尿病的风险较低,且这种关联的程度在不同种族/族裔之间存在显著差异。