Archambault Cyril, Arel Roxane, Filion Kristian B
Cyril Archambault is a medical student at McGill University, Montreal, Quebec.
Roxane Arel, MD, is a staff physician in the Department of Family Medicine, St. Mary's Hospital Center, and a lecturer in the Department of Family Medicine, McGill University, Montreal, Quebec.
Open Med. 2014 Jan 7;8(1):e1-9. eCollection 2014.
Gestational diabetes mellitus is associated with an increased risk of incident type 2 diabetes and has deleterious effects on other cardiovascular risk factors. However, the effect of gestational diabetes on the risk of cardiovascular disease remains unclear. We conducted a scoping review of the literature to examine the association between these 2 conditions.
We systematically searched the PubMed and Embase databases for studies examining the association between gestational diabetes and cardiovascular disease. We restricted our search to studies involving humans that were published in English or French. Outcomes of interest included acute coronary syndromes, angina, arrhythmia, coronary artery disease, heart failure, myocardial infarction, stroke, and composite end points with these outcomes.
A total of 11 publications (3 cohort studies [1 published as an abstract], 2 cross-sectional studies, 1 case-control study [published as an abstract], 4 narrative reviews, and 1 editorial) met our inclusion criteria. The 2 cohort studies published as full manuscripts were conducted in overlapping populations. The included studies reported a range of adjusted relative risks for incident cardiovascular disease, from not significant to 1.85 (95% confidence interval [CI] 1.21 to 2.82). Adjustment for subsequent type 2 diabetes mellitus attenuated the effects but with wide 95% CIs that spanned unity (range 1.13 [95% CI 0.67 to 1.89] to 1.56 [95% CI 1.00 to 2.43]).
Available data suggest that gestational diabetes is associated with an increased risk of cardiovascular disease. However, these data are limited, and evidence regarding this association independent of the increased risk due to subsequent type 2 diabetes and other risk factors for cardiovascular disease remains inconclusive.
妊娠期糖尿病与2型糖尿病发病风险增加相关，且对其他心血管危险因素具有有害影响。然而，妊娠期糖尿病对心血管疾病风险的影响仍不明确。我们对文献进行了一项范围综述，以研究这两种情况之间的关联。
我们系统检索了PubMed和Embase数据库，查找有关妊娠期糖尿病与心血管疾病关联的研究。我们将检索范围限制在以英文或法文发表的涉及人类的研究。感兴趣的结局包括急性冠脉综合征、心绞痛、心律失常、冠状动脉疾病、心力衰竭、心肌梗死、中风以及包含这些结局的复合终点。
共有11篇出版物（3项队列研究[1篇以摘要形式发表]、2项横断面研究、1项病例对照研究[以摘要形式发表]、4篇叙述性综述和1篇社论）符合我们的纳入标准。作为完整手稿发表的2项队列研究是在重叠人群中进行的。纳入研究报告的心血管疾病发病调整相对风险范围较广，从无显著性差异到1.85（95%置信区间[CI]1.21至2.82）。对后续2型糖尿病进行调整后，效应有所减弱，但95%CI较宽，包含1（范围为1.13[95%CI 0.67至1.89]至- 1.56[95%CI 1.00至2.43]）。
现有数据表明，妊娠期糖尿病与心血管疾病风险增加相关。然而，这些数据有限，且关于这种关联独立于后续2型糖尿病及其他心血管疾病危险因素所致风险增加的证据仍不确凿。
