Tsur Noa, Frankel Meir, Cahn Avivit, Tsur Anat
Department of Internal Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Endocrinology Unit, Shaare Zedek Medical Center, Jerusalem, Israel; Department of Endocrinology and Metabolism, Clalit Health Services, Jerusalem, Israel.
J Diabetes Complications. 2024 Apr;38(4):108720. doi: 10.1016/j.jdiacomp.2024.108720. Epub 2024 Mar 4.
To investigate ethnic disparities in risk of gestational diabetes-mellitus (GDM) and future diabetes.
A population-based retrospective cohort study of women who underwent a 100-g oral glucose-tolerance-test (oGTT) during pregnancy between 2007 and 2017 in Clalit-Health-Services of the Jerusalem district. Univariate and multivariate logistic regression analyses were used to compare the risk of GDM in Arab versus Jewish women. Further, Cox-regression analysis was used to establish the risk of future diabetes.
A total of 9875 women, 71 % of Jewish ethnicity and 29 % of Arab ethnicity were included. Arab women had a higher incidence of GDM compared to Jewish women (17.3 % vs. 10.6 %, p < 0.001), which persisted after adjusting for age, BMI, and metabolic profile (aOR 1.7; CI 1.48-2.0, P < 0.001). Additionally, Arab ethnicity was associated with an increased risk of future diabetes, even after adjusting for GDM status (aHR 5.9; 95 % CI 3.7-9.4, P < 0.001).
Women of Arab ethnicity have a higher risk for both GDM and future diabetes, a risk that is beyond the initial increased risk associated with GDM. These findings highlight the need for increased focus on preventing diabetes in women of Arab ethnicity, especially those with a history of GDM.
研究妊娠糖尿病(GDM)风险及未来患糖尿病风险中的种族差异。
对2007年至2017年期间在耶路撒冷地区克拉利特健康服务中心接受100克口服葡萄糖耐量试验(oGTT)的孕妇进行基于人群的回顾性队列研究。采用单因素和多因素逻辑回归分析比较阿拉伯女性和犹太女性患GDM的风险。此外,采用Cox回归分析确定未来患糖尿病的风险。
共纳入9875名女性,其中71%为犹太族,29%为阿拉伯族。与犹太女性相比,阿拉伯女性患GDM的发生率更高(17.3%对10.6%,p<0.001),在调整年龄、体重指数和代谢状况后这一差异仍然存在(调整后比值比1.7;可信区间1.48 - 2.0,P<0.001)。此外,即使在调整GDM状态后,阿拉伯族裔仍与未来患糖尿病的风险增加相关(调整后风险比5.9;95%可信区间3.7 - 9.4,P<0.001)。
阿拉伯族裔女性患GDM和未来患糖尿病的风险更高,这种风险超出了与GDM相关的初始增加风险。这些发现凸显了需要更加关注预防阿拉伯族裔女性患糖尿病,尤其是有GDM病史的女性。