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妊娠合并糖尿病患者产后发生代谢综合征的风险较高。

High risk of metabolic syndrome after delivery in pregnancies complicated by gestational diabetes.

机构信息

Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Six People's Hospital, Shanghai, China.

Tianjin Women's and Children's Health Center, Tianjin, China.

出版信息

Diabetes Res Clin Pract. 2019 Apr;150:219-226. doi: 10.1016/j.diabres.2019.03.030. Epub 2019 Mar 21.

Abstract

AIMS

To investigate the risk of postpartum metabolic syndrome in women with GDM compared with those without GDM in a Chinese population.

METHODS

Tianjin GDM observational study included 1263 women with a history of GDM and 705 women without GDM. Multivariate logistic regression was used to assess risks of postpartum metabolic syndrome between women with and without GDM. Postpartum metabolic syndrome was diagnosed by two commonly used criteria.

RESULTS

During a mean 3.53 years of follow up, 256 cases of metabolic syndrome were identified by using the NCEP ATPIII criteria and 244 cases by using the IDF criteria. Multivariable-adjusted odds ratios of metabolic syndrome in women with GDM compared with those without GDM were 3.66 (95% confidence interval [CI] 2.02-6.63) for NCEP ATPIII criteria and 3.90 (95% CI 2.13-7.14) for IDF criteria. Women with GDM had higher multivariable-adjusted odds ratios of central obesity, hypertriglyceridemia, and high blood pressure than women without GDM. The multivariable-adjusted odds ratios of low HDL cholesterol and hyperglycemia were not significant between women with and without GDM, however, the multivariable-adjusted odds ratio of hyperglycemia became significant when we used the modified criteria.

CONCLUSIONS

The present study indicated that women with prior GDM had significantly higher risks for postpartum metabolic syndrome, as well as its individual components.

摘要

目的

在中国人群中,调查患有 GDM 的女性与无 GDM 的女性相比,产后发生代谢综合征的风险。

方法

天津 GDM 观察性研究纳入了 1263 例有 GDM 病史的女性和 705 例无 GDM 的女性。采用多变量逻辑回归评估 GDM 与无 GDM 女性产后代谢综合征的风险。采用两种常用标准诊断产后代谢综合征。

结果

在平均 3.53 年的随访期间,使用 NCEP ATPIII 标准识别出 256 例代谢综合征病例,使用 IDF 标准识别出 244 例代谢综合征病例。与无 GDM 的女性相比,患有 GDM 的女性发生代谢综合征的多变量校正比值比(95%置信区间)分别为 NCEP ATPIII 标准 3.66(2.02-6.63)和 IDF 标准 3.90(2.13-7.14)。患有 GDM 的女性比无 GDM 的女性发生中心性肥胖、高三酰甘油血症和高血压的多变量校正比值比更高。然而,与无 GDM 的女性相比,患有 GDM 的女性发生低 HDL 胆固醇血症和高血糖症的多变量校正比值比不显著,但当使用改良标准时,高血糖症的多变量校正比值比变得显著。

结论

本研究表明,患有既往 GDM 的女性产后发生代谢综合征及其各组分的风险显著增加。

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