Department of Preventive Medicine, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China.
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana.
Diabetes Obes Metab. 2018 Dec;20(12):2733-2739. doi: 10.1111/dom.13452. Epub 2018 Jul 27.
To investigate the effects of the interaction between glycated haemoglobin (HbA1c) genetic risk score and weight changes during and after pregnancy (postpartum weight reduction and gestational weight gain) on long-term glycaemic changes in the largest cohort of women with a history of gestational diabetes mellitus (GDM).
This was a retrospective cohort using the baseline data from the Tianjin Gestational Diabetes Mellitus Prevention Programme. A genetic risk score was established by combining 10 HbA1c-related single-nucleotide polymorphisms, which were identified by genome-wide association studies. General linear regression models were applied to evaluate the effect of interaction between HbA1c genetic risk score and weight changes during and after pregnancy (postpartum weight reduction and gestational weight gain) on glycaemic changes.
'A total of 1156 women with a history of GDM were included in this respective cohort study. Statistical differences in pre-pregnancy weight, pre-delivery weight and postpartum weight were evidenced across different groups of postpartum weight reduction. After adjusting for covariates, statistical significance for changes in HbA1c level was only observed in the postpartum weight reduction <5 kg/y group (P = 0.002), and a significant effect of interaction between HbA1c genetic risk score and postpartum weight reduction on long-term changes in HbA1c was evidenced (P interaction = 0.01). In women with postpartum weight reduction ≥8 kg/y, those with a lower HbA1c genetic risk score had a greater decrease in HbA1c level.
HbA1c genetic risk score interacts with postpartum weight reduction to affect long-term changes in HbA1c levels among women with a history of GDM.
在最大队列的有妊娠糖尿病史的女性中,研究糖化血红蛋白(HbA1c)遗传风险评分与妊娠期间和产后体重变化(产后体重减轻和妊娠期体重增加)之间的相互作用对长期血糖变化的影响。
这是一项回顾性队列研究,使用了天津妊娠糖尿病预防计划的基线数据。通过全基因组关联研究确定了与 10 个 HbA1c 相关的单核苷酸多态性的遗传风险评分。应用广义线性回归模型来评估 HbA1c 遗传风险评分与妊娠期间和产后体重变化(产后体重减轻和妊娠期体重增加)之间相互作用对血糖变化的影响。
共有 1156 名有妊娠糖尿病史的女性纳入本队列研究。不同产后体重减轻组之间的孕前体重、分娩前体重和产后体重存在统计学差异。在调整了协变量后,仅在产后体重减轻<5kg/y 组中观察到 HbA1c 水平变化有统计学意义(P=0.002),并且在 HbA1c 遗传风险评分和产后体重减轻之间存在显著的交互作用对 HbA1c 长期变化的影响(P 交互=0.01)。在产后体重减轻≥8kg/y 的女性中,HbA1c 遗传风险评分较低的女性 HbA1c 水平下降更大。
HbA1c 遗传风险评分与产后体重减轻相互作用,影响有妊娠糖尿病史的女性长期 HbA1c 水平的变化。