Department of Paediatrics, University of Cambridge, Box 116, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK.
Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, CB2 0QQ, UK.
Acta Diabetol. 2019 Oct;56(10):1133-1140. doi: 10.1007/s00592-019-01354-1. Epub 2019 May 13.
The incidence of gestational diabetes has been reported to have risen over the first decade of this century. Some studies have also found it to vary with seasons of the year. We investigated temporal and seasonal trends on gestational diabetes incidence in a single-centre cohort study from Cambridge, UK, and attempted to explain trends using associated risk factors.
Using a cosinor model, we tested both temporal and seasonal trends in gestational diabetes incidence in 1074 women recruited to the Cambridge Baby Growth Study in 2001-2009 who underwent oral glucose tolerance tests around week 28 of pregnancy.
There was a temporal increase in gestational diabetes incidence over the course of recruitment to this study [0.014 (0.005, 0.022) proportional increase per year, p = 2.1 × 10], but no seasonal effect (p = 0.7). HOMA B [- 0.015 (- 0.025, - 0.005) per year, p = 3.0 × 10] and the insulin disposition index [- 0.036 (- 0.060, - 0.013) per year, p = 3.0 × 10], unlike HOMA S, showed negative temporal trends. Risk factor analyses showed a concomitant temporal slight increase in the index of multiple deprivation [0.191 (0.138, 0.257) units per year, p = 4.6 × 10]. This index was positively associated with HOMA B (p = 6.1 × 10) but not directly with gestational diabetes (p = 0.6), HOMA S (p = 0.2) or the insulin disposition index (p = 0.4).
In this cohort, there were temporal, but not seasonal, increases in gestational diabetes incidence between the years 2001 and 2009, which appeared to be related more to reductions in insulin secretion than sensitivity. Possible mediators of this link include confounding factors related to deprivation.
据报道，妊娠糖尿病的发病率在本世纪初的第一个十年有所上升。一些研究还发现它随一年中的季节而变化。我们在英国剑桥的一项单中心队列研究中调查了妊娠糖尿病发病率的时间和季节性趋势，并试图用相关的危险因素来解释这些趋势。
我们使用余弦模型，检测了 2001 年至 2009 年期间在剑桥婴儿生长研究中招募的 1074 名女性在妊娠 28 周左右进行口服葡萄糖耐量试验时妊娠糖尿病发病率的时间和季节性趋势。
在这项研究的招募过程中，妊娠糖尿病的发病率呈上升趋势[每年增加 0.014（0.005，0.022），p=2.1×10]，但无季节性影响（p=0.7）。HOMA B[-0.015（-0.025，-0.005），每年，p=3.0×10]和胰岛素处置指数[-0.036（-0.060，-0.013），每年，p=3.0×10]，与 HOMA S 不同，呈负时间趋势。危险因素分析显示，在多因素剥夺指数方面，也有轻微的同期时间增加[0.191（0.138，0.257），每年，p=4.6×10]。这个指数与 HOMA B 呈正相关（p=6.1×10），但与妊娠糖尿病（p=0.6）、HOMA S（p=0.2）或胰岛素处置指数（p=0.4）无直接关系。
在这个队列中，2001 年至 2009 年间妊娠糖尿病的发病率呈时间性增加，但无季节性增加，这似乎与胰岛素分泌减少而不是敏感性降低有关。这种联系的可能中介因素包括与贫困有关的混杂因素。
