Department of Obstetrics and Gynaecology, University Hospital Basel, Basel, Switzerland.
Department of Obstetrics and Gynaecology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
Acta Diabetol. 2023 Mar;60(3):345-351. doi: 10.1007/s00592-022-02011-w. Epub 2022 Dec 12.
A family history of type 2 diabetes mellitus (T2DM) markedly increases an individual's lifetime risk of developing the disease. For gestational diabetes (GDM), this risk factor is less well characterized. This study aimed to investigate the relationship between family history of T2DM in first- and second-degree relatives in women with GDM and the differences in metabolic characteristics at early gestation.
This prospective cohort study included 1129 pregnant women. A broad risk evaluation was performed before 16 + 0 weeks of gestation, including a detailed family history of the different types of diabetes and a laboratory examination of glucometabolic parameters. Participants were followed up until delivery and GDM assessed according to the latest diagnosis criteria.
We showed that pregnant women with first- (FHD1, 26.6%, OR 1.91, 95%CI 1.16 to 3.16, p = 0.005), second- (FHD2, 26.3%, OR 1.88, 95%CI 1.16 to 3.05, p = 0.005) or both first- and second-degree relatives with T2DM (FHD1 + D2, 33.3%, OR 2.64, 95%CI 1.41 to 4.94, p < 0.001) had a markedly increased risk of GDM compared to those with negative family history (FHN) (n = 100, 15.9%). The association was strongest if both parents were affected (OR 4.69, 95%CI 1.33 to 16.55, p = 0.009). Women with FHD1 and FHD1 + D2 had adverse glucometabolic profiles already in early pregnancy.
Family history of T2DM is an important risk factor for GDM, also by applying the current diagnostic criteria. Furthermore, we showed that the degree of kinship plays an essential role in quantifying the risk already at early pregnancy.
2 型糖尿病（T2DM）家族史显著增加个体患该病的终生风险。对于妊娠糖尿病（GDM），这种风险因素的特征描述较少。本研究旨在探讨 GDM 女性一级和二级亲属中 T2DM 家族史与早期妊娠代谢特征差异之间的关系。
本前瞻性队列研究纳入了 1129 名孕妇。在 16+0 周之前进行了广泛的风险评估，包括不同类型糖尿病的详细家族史和糖代谢参数的实验室检查。参与者一直随访到分娩，并根据最新诊断标准评估 GDM。
我们发现，一级亲属（FHD1，26.6%，OR 1.91，95%CI 1.16 至 3.16，p=0.005）、二级亲属（FHD2，26.3%，OR 1.88，95%CI 1.16 至 3.05，p=0.005）或一级和二级亲属均有 T2DM（FHD1+D2，33.3%，OR 2.64，95%CI 1.41 至 4.94，p<0.001）的孕妇与无家族史（FHN）（n=100，15.9%）的孕妇相比，GDM 风险显著增加。如果父母双方均受影响（OR 4.69，95%CI 1.33 至 16.55，p=0.009），则相关性最强。FHD1 和 FHD1+D2 的女性在早期妊娠时即存在不良糖代谢谱。
T2DM 家族史是 GDM 的一个重要危险因素，即使应用目前的诊断标准也是如此。此外，我们还表明，亲属关系的程度在早期妊娠时已经对风险的量化起着重要作用。
