Fuchs Oded, Sheiner Eyal, Meirovitz Mihai, Davidson Ehud, Sergienko Ruslan, Kessous Roy
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel.
Soroka University Medical Center, Clalit Health Services (Southern District), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Arch Gynecol Obstet. 2017 Mar;295(3):731-736. doi: 10.1007/s00404-016-4275-7. Epub 2016 Dec 29.
To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased future risk for female malignancies.
A population-based study compared the incidence of long-term female malignancies (ovary, uterine, breast, and uterine cervix) in a cohort of women with and without a diagnosis of GDM. Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years. Women with known malignancies prior to the index pregnancy were excluded. Kaplan-Meier survival curve was used to estimate cumulative incidence of malignancies. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for female malignancy.
During the study period, 1,04,715 deliveries met the inclusion criteria; 9.4% (n = 9893) occurred in patients with a history of GDM in at least one of their pregnancies. During the follow-up period, patients with GDM had a significantly increased risk of being diagnosed with female malignancies, including ovarian, uterine, and breast cancer. Using a Kaplan-Meier survival curve, patients with a previous diagnosis of GDM had a significantly higher cumulative incidence of female malignancies. Using a Cox proportional hazards model, adjusted for confounders, such as parity, maternal age, and fertility treatments, a history of GDM remained independently associated with female malignancies (adjusted HR, 1.3; 95% CI 1.2-1.6; P = 0.001).
Patients with a history of GDM have an increased risk for future breast, ovarian, and uterine malignancies.
探讨有妊娠期糖尿病（GDM）病史的患者未来发生女性恶性肿瘤的风险是否增加。
一项基于人群的研究比较了有和没有GDM诊断的女性队列中女性长期恶性肿瘤（卵巢、子宫、乳腺和子宫颈）的发病率。分娩发生在1988年至2013年之间，平均随访时间为12年。排除在本次妊娠前已知患有恶性肿瘤的女性。采用Kaplan-Meier生存曲线估计恶性肿瘤的累积发病率。使用Cox比例风险模型估计女性恶性肿瘤的调整风险比（HR）。
在研究期间，104715例分娩符合纳入标准；其中9.4%（n = 9893）发生在至少有一次妊娠有GDM病史的患者中。在随访期间，GDM患者被诊断为女性恶性肿瘤（包括卵巢癌、子宫癌和乳腺癌）的风险显著增加。使用Kaplan-Meier生存曲线，既往诊断为GDM的患者女性恶性肿瘤的累积发病率显著更高。使用Cox比例风险模型，在对诸如产次、产妇年龄和生育治疗等混杂因素进行调整后，GDM病史仍与女性恶性肿瘤独立相关（调整后HR，1.3；95%CI 1.2 - 1.6；P = 0.001）。
有GDM病史的患者未来发生乳腺、卵巢和子宫恶性肿瘤的风险增加。
