Nouhjah Sedigheh, Shahbazian Hajieh, Shahbazian Nahid, Jahanfar Shayesteh, Jahanshahi Alireza, Cheraghian Bahman, Mohammadi Zeinab Dehghan, Ghodrati Niloofar, Houshmandi Sousan
Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Diabetes Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Diabetes Metab Syndr. 2018 May;12(3):317-323. doi: 10.1016/j.dsx.2017.12.027. Epub 2017 Dec 22.
This study aimed to determine the prevalence rate of metabolic syndrome and its potential risk factors, 6-12 weeks postpartum in women with GDM compared to women with normal glucose tolerance.
LAGAs is an ongoing population-based prospective cohort study that started in March 2015 in Ahvaz, Iran. During 11 months of study progression, 176 women with GDM pregnancy and 86 healthy women underwent a fasting glucose test, 75-g OGTT and fasting lipid tests at 6-12 weeks postpartum. GDM was defined based on IADPSG criteria. Postpartum glucose intolerance was defined according to ADA criteria and metabolic syndrome using 2 sets of criteria.
The overall rate of metabolic syndrome at 6-12 weeks postpartum was 16% by NCEP-ATP III criteria (18.2% in women with GDM and 11.6% in controls) and 19.1% by IDF criteria (21% in women with gestational diabetes and 15.1% in controls). Pre-pregnancy overweight or obesity, (OR 1.89, 95% CI: 1.05-3.38, P = .03), pregnancy systolic blood pressure (OR 1.03, 95% CI: 1.008-1.52, P = .006) and requiring insulin or metformin (OR 3.08, 95% CI: 1.25-7.60, P = 0.01), were associated risk factors for the presence of MetS in GDM-exposed women. In women with normal glucose during pregnancy, pre-pregnancy BMI ≥25 kg/m was a risk factor of metabolic syndrome (OR 2.82, 95% CI: 1.11-7.15, P = .02).
The rate of metabolic syndrome in women with or without GDM at 6-12 weeks postpartum is high particularly in women with high BMI. An early postpartum prevention and screening program for cardiovascular risk factors is important for women with GDM.
本研究旨在确定与糖耐量正常的女性相比,妊娠期糖尿病(GDM)女性产后6 - 12周代谢综合征的患病率及其潜在危险因素。
LAGAs是一项正在进行的基于人群的前瞻性队列研究,于2015年3月在伊朗阿瓦士启动。在研究进行的11个月期间,176例患有GDM的孕妇和86例健康女性在产后6 - 12周接受了空腹血糖测试、75克口服葡萄糖耐量试验(OGTT)和空腹血脂测试。GDM根据国际糖尿病与妊娠研究组协会(IADPSG)标准定义。产后葡萄糖不耐受根据美国糖尿病协会(ADA)标准定义,代谢综合征使用两套标准定义。
根据美国国家胆固醇教育计划成人治疗组第三次报告(NCEP - ATP III)标准,产后6 - 12周代谢综合征的总体发生率为16%(GDM女性中为18.2%,对照组中为11.6%);根据国际糖尿病联盟(IDF)标准,发生率为19.1%(妊娠期糖尿病女性中为21%,对照组中为15.1%)。孕前超重或肥胖(比值比[OR] 1.89,95%置信区间[CI]:1.05 - 3.38,P = 0.03)、妊娠收缩压(OR 1.03,95% CI:1.008 - 1.52,P = 0.006)以及需要使用胰岛素或二甲双胍(OR 3.08,95% CI:1.25 - 7.60,P = 0.01)是GDM暴露女性中存在代谢综合征的相关危险因素。在孕期血糖正常的女性中,孕前体重指数(BMI)≥25 kg/m²是代谢综合征的一个危险因素(OR 2.82,95% CI:1.11 - 7.15,P = 0.02)。
产后6 - 12周有或无GDM的女性中代谢综合征的发生率较高,尤其是BMI较高的女性。对GDM女性而言,开展产后早期心血管危险因素预防和筛查项目很重要。