Monash Centre for Health Research and Implementation, Monash University, 3168 Clayton, Australia.
Deakin Rural Health, School of Medicine, Deakin University, 3217 Geelong, Australia.
Nutrients. 2019 Apr 24;11(4):922. doi: 10.3390/nu11040922.
Weight gain after childbirth is a significant risk factor for type 2 diabetes (T2DM) development after gestational diabetes mellitus (GDM). The level of weight loss achieved in diabetes prevention programs for women after GDM is often low but its effects on the cardiometabolic risk are not known. In a secondary analysis of a diabetes prevention program in postpartum women with history of gestational diabetes, we evaluated the effect of weight change on the cardiometabolic outcomes at 1-year follow-up. Of the 284 women randomized to the intervention arm, 206 with the final outcome measurements were included in the analyses. Participants were categorized into weight loss (>2 kg, = 74), weight stable (±2 kg, = 74) or weight gain (>2 kg, = 58) groups. The weight loss group had significantly greater decrease in glycated hemoglobin (HbA1c) than the weight gain group (-0.1 + 0.4% vs. 0 + 0.4%, = 0.049). The weight loss group had significantly greater decrease in total cholesterol and low-density lipoprotein cholesterol cholesterol than the other two groups ( < 0.05). The weight gain group had significantly greater increase in triglyceride and triglyceride:high-density lipoprotein cholesterol ratio compare with the other groups ( < 0.01). Overall, a small amount of weight loss and prevention of further weight gain was beneficial to the cardiometabolic outcomes of postpartum women after GDM.
产后体重增加是妊娠糖尿病（GDM）后 2 型糖尿病（T2DM）发展的一个重要危险因素。GDM 后妇女糖尿病预防计划中实现的减肥水平通常较低，但尚不清楚其对心血管代谢风险的影响。在对有 GDM 病史的产后妇女进行的糖尿病预防计划的二次分析中，我们评估了体重变化对 1 年随访时心血管代谢结局的影响。在被随机分配到干预组的 284 名女性中，有 206 名最终有结局测量值的女性被纳入分析。参与者被分为体重减轻（>2kg，n=74）、体重稳定（±2kg，n=74）或体重增加（>2kg，n=58）组。与体重增加组相比，体重减轻组的糖化血红蛋白（HbA1c）下降幅度明显更大（-0.1±0.4% vs. 0.0+0.4%， = 0.049）。与其他两组相比，体重减轻组的总胆固醇和低密度脂蛋白胆固醇（LDL-C）下降幅度明显更大（<0.05）。与其他两组相比，体重增加组的甘油三酯和甘油三酯：高密度脂蛋白胆固醇比值增加幅度明显更大（<0.01）。总的来说，少量的体重减轻和预防体重进一步增加有利于 GDM 后产后妇女的心血管代谢结局。
