母体中心型肥胖与妊娠期糖尿病发病风险的关系：一项队列研究的系统评价和荟萃分析。
Relationship between Maternal Central Obesity and the Risk of Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies.
机构信息
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
Clinical Research Center, Shengjing Hospital of China Medical University, Shenyang, China.
出版信息
J Diabetes Res. 2020 Apr 2;2020:6303820. doi: 10.1155/2020/6303820. eCollection 2020.
OBJECTIVE
Nowadays, body mass index (BMI) is used to evaluate the risk stratification of obesity-related pregnancy complications in clinics. However, BMI cannot reflect fat distribution or the proportion of adipose to nonadipose tissue. The objective of this study is to evaluate the association of maternal first or second trimester central obesity with the risk of GDM. . We searched in PubMed, Embase, and Web of Science for English-language medical literature published up to 12 May 2019. Cohort studies were only included in the search. Abdominal subcutaneous fat thickness, waist circumference, waist-hip ratio or body fat distribution were elected as measures of maternal central obesity, and all diagnostic criteria for GDM were accepted. The random effect meta-analysis was performed to evaluate the relationship between central obesity and the risk of GDM.
RESULTS
A total of 11 cohort studies with an overall sample size of 27,675 women and 2,226 patients with GDM were included in the analysis. The summary estimate of GDM risk in the central obesity pregnant women was 2.76 (95% confidence interval [CI]: 2.35-3.26) using the adjusted odds ratio (OR). The degree of heterogeneity among the studies was low ( = 14.4, = 0.307). The subgroup analyses showed that heterogeneity was affected by selected study characteristics (methods of exposure and trimesters). After adjusting for potential confounds, the OR of adjusted BMI was significant (OR = 3.07, 95% CI: 2.35-4.00).
CONCLUSIONS
Our findings indicate that the risk of GDM was positively associated with maternal central obesity.
目的
目前，体重指数（BMI）用于评估临床肥胖相关妊娠并发症的风险分层。然而，BMI 不能反映脂肪分布或脂肪与非脂肪组织的比例。本研究旨在评估孕妇第一或第二孕期中心性肥胖与 GDM 风险的关系。我们在 PubMed、Embase 和 Web of Science 中搜索了截至 2019 年 5 月 12 日发表的英文医学文献。仅纳入队列研究。腹部皮下脂肪厚度、腰围、腰臀比或体脂分布被选为孕妇中心性肥胖的衡量指标，接受所有 GDM 的诊断标准。采用随机效应荟萃分析评估中心性肥胖与 GDM 风险的关系。
结果
共纳入 11 项队列研究，总计 27675 名妇女和 2226 例 GDM 患者。使用校正比值比（OR），中心性肥胖孕妇 GDM 的风险综合估计值为 2.76（95%置信区间[CI]：2.35-3.26）。研究间的异质性程度较低（ = 14.4， = 0.307）。亚组分析表明，选择的暴露和孕期方法会影响异质性。在调整潜在混杂因素后，校正 BMI 的 OR 有统计学意义（OR = 3.07，95% CI：2.35-4.00）。
结论
我们的研究结果表明，GDM 的风险与孕妇中心性肥胖呈正相关。
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