Department of Obstetrics and Gynecology, Suzhou Medical College of Soochow University, Suzhou, China.
Department of Obstetrics and Gynecology, The First People's Hospital of Kunshan Affiliated With Jiangsu University, Suzhou, China.
Front Public Health. 2022 Jul 5;10:940335. doi: 10.3389/fpubh.2022.940335. eCollection 2022.
Gestational diabetes mellitus (GDM) has been linked to subsequent overall cardiovascular diseases. However, evidence on the associations of GDM with type-specific cardiovascular diseases is lacking, and findings on the potential impact of type 2 diabetes on the associations are not consistent. This study aimed to explore the associations between GDM and the risks of type-specific cardiovascular diseases.
Data were from 12,025 women (≥20 years) who had delivered at least one live birth in the National Health and Nutrition Examination Survey, 2007-2018. GDM history and type-specific cardiovascular diseases including coronary heart disease (CHD), heart failure and stroke were defined by self-report. We also combined our results with those from previously related publications on the associations between GDM and risks of type-specific cardiovascular diseases with a random-effect model.
Compared with women without GDM, the multivariable-adjusted odds ratios (95% confidence intervals) were 1.82 (1.21-2.72) for CHD, 1.43 (0.80-2.53) for heart failure, and 1.19 (0.76-1.86) for stroke among women with a history of GDM. Type 2 diabetes was associated with 43.90, 67.44, and 63.16% of the excess odds of CHD, heart failure and stroke associated with GDM, respectively. Combining results from this study with those from previously related studies yielded odds ratios (95% confidence intervals) of 1.81 (1.60-2.05) for CHD (12 studies, 7,615,322 participants, = 72.6%), 1.66 (1.25-2.21) for heart failure (5 studies, 4,491,665 participants, = 88.6%), and 1.25 (1.07-1.46) for cerebrovascular disease (9 studies, 6,090,848 participants, = 77.8%).
GDM showed stronger associations with coronary heart diseases and heart failure than cerebrovascular disease, and the excess risks are attributable, in part, to type 2 diabetes.
妊娠期糖尿病（GDM）与随后的整体心血管疾病有关。然而，关于 GDM 与特定类型心血管疾病的关联的证据尚缺乏，且关于 2 型糖尿病对这些关联的潜在影响的研究结果也不一致。本研究旨在探讨 GDM 与特定类型心血管疾病风险之间的关系。
本研究数据来自于 12025 名（≥20 岁）在 2007 年至 2018 年期间至少分娩过一次活产儿的全国健康和营养调查参与者。GDM 病史和特定类型的心血管疾病（包括冠心病、心力衰竭和中风）通过自我报告进行定义。我们还通过随机效应模型，将我们的研究结果与之前关于 GDM 与特定类型心血管疾病风险之间关联的相关出版物的结果相结合。
与无 GDM 的女性相比，有 GDM 病史的女性患冠心病的多变量调整比值比（95%置信区间）为 1.82（1.21-2.72），患心力衰竭的比值比为 1.43（0.80-2.53），患中风的比值比为 1.19（0.76-1.86）。2 型糖尿病与 GDM 相关的冠心病、心力衰竭和中风的超额比值比分别为 43.90%、67.44%和 63.16%。将本研究结果与之前的相关研究结果相结合，得到冠心病（12 项研究，7615322 名参与者，=72.6%）、心力衰竭（5 项研究，4491665 名参与者，=88.6%）和脑血管疾病（9 项研究，6090848 名参与者，=77.8%）的比值比（95%置信区间）分别为 1.81（1.60-2.05）、1.66（1.25-2.21）和 1.25（1.07-1.46）。
GDM 与冠心病和心力衰竭的相关性强于脑血管疾病，且这些风险的增加部分归因于 2 型糖尿病。
