Public Health Research, DLH Holdings Corporation, Atlanta, Georgia, USA
National Institute of Minority Health and Health Disparities, Division of Intramural Research, Bethesda, Maryland, USA.
BMJ Open Diabetes Res Care. 2022 Nov;10(6). doi: 10.1136/bmjdrc-2022-002980.
Type 2 diabetes and gestational diabetes (GDM) disproportionately affect those of Hispanic/Latino heritage. This study examined the association between GDM and prevalent and incident diabetes in a community-based study of Hispanic/Latina women living in the USA.
Participants were women aged 18-74 years in the Hispanic Community Health Study/Study of Latinos who had at least one pregnancy and had information on self-reported history of GDM at baseline (n=6389). Logistic regression was used to determine the association between GDM and prevalent (2008-2011) and incident (2014-2017) diabetes and interactions between GDM and risk factors for incident diabetes.
At baseline, 8.7% of participants reported a history of GDM and 18.6% had prevalent diabetes. Women with Mexican heritage had the highest prevalence of GDM history (11.3%) vs women of Cuban (5.0%), Central American (4.9%), and South American (3.8%) heritage (p<0.001 for each comparison to Mexican heritage). Women with self-reported GDM were four times more likely to have prevalent diabetes compared with women without GDM, after adjusting for sociodemographic characteristics and cardiometabolic risk factors (adjusted OR (aOR)=3.94, 95% CI 2.75 to 5.64). Overall incidence of diabetes was 14.3/100 women. Women with GDM at baseline increased their odds of incident diabetes by threefold compared with women without GDM (aOR=3.25, 95% CI 2.09 to 5.05). Women with Cuban or Puerto Rican heritage and GDM had significantly higher odds of incident diabetes compared with women with Mexican heritage (aOR=2.15, 95% CI 1.17 to 3.95; aOR=1.95, 95% CI 1.07 to 3.55, respectively).
Self-reported GDM was significantly associated with a threefold higher risk of incident diabetes among Hispanic/Latino women in the USA even after adjusting for several significant predictors of diabetes.
2 型糖尿病和妊娠糖尿病（GDM）在西班牙裔/拉丁裔人群中的发病率不成比例。本研究在美国进行的一项以西班牙裔/拉丁裔女性为基础的研究中，调查了 GDM 与现患和新发糖尿病之间的关系。
研究对象为参加西班牙裔社区健康研究/拉丁裔研究的年龄在 18-74 岁之间、至少有一次妊娠且在基线时有自我报告 GDM 病史的女性（n=6389）。采用逻辑回归分析 GDM 与现患（2008-2011 年）和新发（2014-2017 年）糖尿病之间的关系，以及 GDM 与新发糖尿病危险因素之间的交互作用。
基线时，8.7%的参与者报告有 GDM 病史，18.6%的参与者患有现患糖尿病。具有墨西哥裔血统的女性 GDM 病史发生率最高（11.3%），而古巴裔（5.0%）、中美洲裔（4.9%）和南美洲裔（3.8%）女性的 GDM 病史发生率较低（与墨西哥裔相比，每种比较均 P<0.001）。在调整了社会人口特征和心血管代谢危险因素后，自我报告有 GDM 的女性患现患糖尿病的可能性是没有 GDM 的女性的四倍（调整后的比值比（aOR）=3.94，95%CI 2.75 至 5.64）。总的糖尿病发病率为 14.3/100 名女性。与没有 GDM 的女性相比，基线时有 GDM 的女性新发糖尿病的风险增加了两倍（aOR=3.25，95%CI 2.09 至 5.05）。具有古巴或波多黎各血统且患有 GDM 的女性与具有墨西哥血统的女性相比，新发糖尿病的风险显著更高（aOR=2.15，95%CI 1.17 至 3.95；aOR=1.95，95%CI 1.07 至 3.55）。
即使在校正了糖尿病的几个重要预测因素后，美国西班牙裔/拉丁裔女性自我报告的 GDM 与新发糖尿病的风险增加三倍显著相关。
