既往妊娠糖尿病对 2 型糖尿病长期并发症的影响。

Impact of prior gestational diabetes on long-term type 2 diabetes complications.

机构信息

Department of Obstetrics and Gynecology at Medical College of Wisconsin, 9200 W Wisconsin Ave, Milwaukee, WI 53226, United States of America.

出版信息

J Diabetes Complications. 2022 Sep;36(9):108282. doi: 10.1016/j.jdiacomp.2022.108282. Epub 2022 Aug 2.

DOI:10.1016/j.jdiacomp.2022.108282

PMID:35933918

Abstract

AIMS

While women with gestational diabetes mellitus (GDM) have a higher risk of developing type 2 diabetes mellitus (T2DM) and at a younger age, it is unknown whether T2DM following GDM is associated with worse clinical outcomes. This study aims to examine the impact of GDM on subsequent development of long-term complications of T2DM.

METHODS

All women with T2DM from the National Health and Nutrition Examination Survey (NHANES), a nationally representative cross-sectional survey of US population, between 2007 and 2018 (n = 2494) were stratified into two groups: those with a history of GDM (n = 385) and those without (n = 2109). Rates of macrovascular and microvascular complications of T2DM were compared between the two groups using bivariate and multivariate analyses.

RESULTS

Of 2494 participants with T2DM included in the analysis, 385 (15.4 %) had a history of GDM and 2109 (84.6 %) did not. A history of GDM was independently associated with increased risk of myocardial infarction (aOR 2.53, 95%Cl: 1.18-5.40) and likely coronary artery disease (aOR 2.15, 95 % Cl: 1.00-4.66).

CONCLUSIONS

In this cohort, women with T2DM and a history of GDM had higher risk of macrovascular complications of myocardial infarction and coronary artery disease, compared to those with no history of gestational diabetes.

摘要

目的

患有妊娠糖尿病（GDM）的女性发生 2 型糖尿病（T2DM）的风险更高，且发病年龄更早，但 GDM 后发生的 T2DM 是否与更差的临床结局相关尚不清楚。本研究旨在探讨 GDM 对 T2DM 长期并发症发生的影响。

方法

本研究纳入了 2007 年至 2018 年全美健康和营养调查（NHANES）中患有 T2DM 的所有女性（n=2494），这些女性来自具有美国代表性的横断面研究人群，将其分为两组：有 GDM 病史组（n=385）和无 GDM 病史组（n=2109）。采用双变量和多变量分析比较两组 T2DM 大血管和微血管并发症的发生率。

结果

在纳入分析的 2494 例 T2DM 患者中，有 385 例（15.4%）有 GDM 病史，2109 例（84.6%）无 GDM 病史。GDM 病史与心肌梗死风险增加独立相关（OR 2.53，95%CI：1.18-5.40），且可能与冠状动脉疾病相关（OR 2.15，95%Cl：1.00-4.66）。