Department of Obstetrics and Gynaecology, Department of Clinical and Experimental Medicine, Linköping University, 581 85, Linköping, Sweden.
Department of Molecular Medicine and Surgery, Karolinska University Hospital, Karolinska Institutet, 171 76, Stockholm, Sweden.
Sci Rep. 2023 Sep 30;13(1):16427. doi: 10.1038/s41598-023-43014-z.
Studies have shown that preeclampsia is associated insulin resistance and cardiovascular events later in life. However, knowledge is lacking regarding a possible association between PE and abnormal glucose tolerance/prediabetes. Thus, the current study aimed to compare the prevalence of prediabetes in women with previous severe preeclampsia to women with previous normotensive pregnancies. Women with severe preeclampsia (index women, n = 45) admitted to Danderyds University Hospital in 1999-2004 were compared to women with normotensive pregnancies, matched for age, parity, and year of delivery (control women, n = 53). In 2013-2016 BMI, blood pressure, waist circumference, insulin, C-peptide, hsCRP, Cystatin C, HDL, triglycerides, and HbA1c were measured and an OGTT was performed. Index women had a higher BMI (p < 0.001) and blood pressure (p < 0.001) in early pregnancy. At follow-up, prediabetes was more common among index women (p = 0.001), as were hypertension (p = 0.003), heredity for diabetes/cardiovascular disease (p = 0.020), and a larger waist circumference (p = 0.024). Preeclampsia increased the risk of having a fasting plasma glucose ≥ 5.6 mmol/l (aOR 7.28, 95% CI 2.44-21.76) and of prediabetes 11-16 years after index pregnancy (aOR 4.83, 95% CI 1.80-12.97). In conclusion, preeclampsia increases the risk of prediabetes independent of heredity, hypertension, and waist circumference. These findings may have implications for screening and prevention.
研究表明，先兆子痫与胰岛素抵抗和日后的心血管事件有关。然而，关于先兆子痫与异常葡萄糖耐量/糖尿病前期之间的可能关联，目前知之甚少。因此，本研究旨在比较既往重度子痫前期妇女与既往正常血压妊娠妇女的糖尿病前期患病率。将 1999-2004 年在 Danderyds 大学医院住院的 45 例重度子痫前期患者（指数妇女）与年龄、产次和分娩年份相匹配的正常血压妊娠妇女（对照妇女，n=53）进行比较。于 2013-2016 年测量 BMI、血压、腰围、胰岛素、C 肽、hsCRP、胱抑素 C、HDL、甘油三酯和 HbA1c，并进行 OGTT。指数妇女在早孕时 BMI（p<0.001）和血压（p<0.001）更高。随访时，指数妇女的糖尿病前期更为常见（p=0.001），高血压（p=0.003）、糖尿病/心血管疾病家族史（p=0.020）和更大的腰围（p=0.024）也更为常见。子痫前期使空腹血糖≥5.6mmol/l 的风险增加（OR 7.28，95%CI 2.44-21.76），以及 11-16 年后发生糖尿病前期的风险增加（OR 4.83，95%CI 1.80-12.97）。总之，子痫前期独立于遗传、高血压和腰围增加发生糖尿病前期的风险。这些发现可能对筛查和预防具有重要意义。
