Noctor Eoin, Crowe Catherine, Carmody Louise A, Kirwan Breda, O'Dea Angela, Glynn Liam G, McGuire Brian E, O'Shea Paula M, Dunne Fidelma P
Galway Diabetes Research Centre, National University of Ireland, Galway, Ireland,
Acta Diabetol. 2015 Feb;52(1):153-60. doi: 10.1007/s00592-014-0621-z. Epub 2014 Jul 8.
Women with previous gestational diabetes (GDM) are a high-risk group for future development of diabetes, metabolic syndrome, and cardiovascular disease. The new International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria significantly increase the number of women diagnosed with GDM. The long-term metabolic outcome in these women is unknown. We set out to determine the prevalence of metabolic syndrome, using adult treatment panel-III criteria; and insulin resistance, using HOMA2-IR, in white European women with previous GDM. Using a cohort design, we invited women meeting IADPSG GDM criteria across four Irish antenatal centres between 2007 and 2010 to participate. Two hundred and sixty-five women with previous values meeting IADPSG criteria for GDM participated (44 % of the population eligible for participation). Mean age was 36.7 years (SD 5.0). These women were compared with a randomly selected control group of 378 women (mean age 37.6 years, SD 5.1) known to have normal glucose tolerance (NGT) in pregnancy during the same period. A total of 25.3 % of women with previous IADPSG-defined GDM met metabolic syndrome criteria, compared to 6.6 % of women with NGT [at 2.6 (SD 1.0) vs. 3.3 years (SD 0.7) post-partum]. The prevalence of HOMA2-IR >1.8 was higher in women with previous IADPSG-defined GDM (33.6 vs. 9.1 % with NGT, p < 0.001). Women with previous GDM by IADPSG criteria demonstrate a greater than threefold prevalence of metabolic syndrome compared to women with NGT in pregnancy. Efforts to prevent projected long-term consequences of this should focus on interventions both in the preconception and post-partum periods.
既往患有妊娠期糖尿病（GDM）的女性是未来发生糖尿病、代谢综合征和心血管疾病的高危人群。新的国际妊娠糖尿病研究组协会（IADPSG）标准显著增加了被诊断为GDM的女性数量。这些女性的长期代谢结局尚不清楚。我们旨在确定符合成人治疗小组III标准的代谢综合征患病率，以及使用HOMA2-IR确定既往患有GDM的欧洲白人女性的胰岛素抵抗情况。采用队列设计，我们邀请了2007年至2010年间在爱尔兰四个产前中心符合IADPSG GDM标准的女性参与研究。265名既往符合IADPSG GDM标准的女性参与了研究（占 eligible for participation的44%）。平均年龄为36.7岁（标准差5.0）。将这些女性与同期随机选择的378名已知孕期糖耐量正常（NGT）的女性对照组进行比较（平均年龄37.6岁，标准差5.1）。既往符合IADPSG定义的GDM的女性中，共有25.3%符合代谢综合征标准，而NGT女性为6.6%[产后2.6（标准差1.0）年与3.3年（标准差0.7）]。既往符合IADPSG定义的GDM的女性中，HOMA2-IR>1.8的患病率更高（33.6%对NGT的9.1%，p<0.001）。与孕期糖耐量正常的女性相比，符合IADPSG标准的既往患有GDM的女性代谢综合征患病率高出三倍以上。为预防由此产生的预计长期后果所做的努力应集中在孕前和产后阶段的干预措施上。
