Prados Montserrat, Flores-Le Roux Juana A, Benaiges David, Llauradó Gemma, Chillarón Juan J, Paya Antoni, Pedro-Botet Juan
Department of Internal Medicine, Hospital Sant Joan de Deu de Martorell, Mancomunitats Comarcals Avenue 1-3, Martorell, 08760 Barcelona, Spain.
Department of Medicine, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Lipids. 2018 Apr;53(4):387-392. doi: 10.1002/lipd.12040. Epub 2018 May 6.
In a cohort of women with previous gestational diabetes mellitus (GDM), we aimed to ascertain whether women with abnormal glucose tolerance 1-year postdelivery had a more atherogenic lipid profile during and after pregnancy than those with normal glucose tolerance. A prospective cohort study with longitudinal design between January 2004 and March 2016 was conducted. Three hundred and six (56.8%) of 537 women diagnosed with GDM during the studied period attended a control visit during the first year after delivery. Of these, 112 (36.6%) had prediabetes and 16 (5.2%) had type 2 diabetes mellitus. No significant differences during pregnancy were found in total, low-density lipoprotein, high-density lipoprotein (HDL) cholesterol, and triacylglycerol (TAG) concentrations among the three groups. Only HDL cholesterol and TAG levels differed significantly among groups at 2 and 12 months after delivery. Logistic regression analysis revealed pregnancy HDL and glucose metabolism status to be associated with the HDL cholesterol concentration 1-year postdelivery. Furthermore, the only independent factor associated with TAG levels 1 year after delivery was the gestational TAG concentration. In summary, an overweight multiethnic group of women with prior GDM presented a high incidence of postpartum dysglycemia (41.8%). HDL-cholesterol and TAG levels, both components of the metabolic syndrome, differed significantly among the three study groups in the glucose-metabolism status at 2 and 12 months after delivery. Women with previous GDM must be followed up in the postpartum period for early detection and management of lipid and glucose disorders.
在一组既往有妊娠期糖尿病(GDM)的女性中,我们旨在确定产后1年糖耐量异常的女性在孕期及产后是否比糖耐量正常的女性具有更易致动脉粥样硬化的血脂谱。我们进行了一项前瞻性队列研究,研究时间为2004年1月至2016年3月,采用纵向设计。在研究期间被诊断为GDM的537名女性中,有306名(56.8%)在产后第一年进行了对照访视。其中,112名(36.6%)有糖尿病前期,16名(5.2%)有2型糖尿病。三组之间在孕期的总胆固醇、低密度脂蛋白、高密度脂蛋白(HDL)胆固醇和三酰甘油(TAG)浓度方面未发现显著差异。仅在产后2个月和12个月时,各组之间的HDL胆固醇和TAG水平存在显著差异。逻辑回归分析显示,孕期HDL和糖代谢状态与产后1年的HDL胆固醇浓度相关。此外,与产后1年TAG水平相关的唯一独立因素是孕期TAG浓度。总之,一组有既往GDM的超重多民族女性产后血糖异常的发生率较高(41.8%)。代谢综合征的两个组成部分HDL胆固醇和TAG水平,在产后2个月和12个月时,三个研究组在糖代谢状态方面存在显著差异。既往有GDM的女性在产后必须进行随访,以便早期发现和管理脂质和血糖紊乱。