Vanlaer Yana, Minschart Caro, Van den Keybus Karolijn, Myngheer Nele, Maes Toon, De Block Christophe, Bochanen Niels, Van Pottelbergh Inge, Abrams Pascale, Vinck Wouter, Leuridan Liesbeth, Driessens Sabien, Billen Jaak, Matthys Christophe, Bogaerts Annick, Laenen Annouschka, Mathieu Chantal, Benhalima Katrien
Department of Chronic Diseases and Metabolism, Clinical and Experimental Endocrinology, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
Faculty of Medicine, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.
J Clin Med. 2025 May 21;14(10):3592. doi: 10.3390/jcm14103592.
To examine the association between depressive symptoms and metabolic profile in women with prior gestational diabetes mellitus (GDM) and early postpartum prediabetes, and to explore whether a mobile-based lifestyle intervention affected mental health outcomes. Secondary, exploratory analysis of a multi-centric randomized controlled trial (MELINDA), evaluating a mobile-based lifestyle intervention versus standard follow-up (control group) in women with prediabetes after GDM. The analysis included 166 participants who completed the Center for Epidemiologic Studies-Depression (CES-D) questionnaire [score of ≥16 being suggestive for (sub)clinical depression] at baseline (6-16 weeks postpartum) and one year post-randomization. At one year, 26.5% of women (n = 44) reported depressive symptoms, with no significant difference between the intervention and control groups (30.5% vs. 22.6%, = 0.293). Women with depressive symptoms (symptomatic women) were younger (30.9 ± 4.9 vs. 32.5 ± 3.8 years, = 0.033) and were less often highly educated (61.4% vs. 80.3%, = 0.028). At baseline, symptomatic women had a higher rate of metabolic syndrome (38.6% vs. 21.9%, = 0.044), higher LDL-cholesterol [3.2 ± 0.8 vs. 2.8 ± 0.8 mmol/L, = 0.009], lower quality of life (lower SF-36 scores, < 0.050) and a higher level of anxiety based on the STAI-6 questionnaire (14.5 ± 3.6 vs. 11.2 ± 2.6, < 0.001). These differences persisted at one year postpartum with worse metabolic profile, more anxiety and lower quality of life in symptomatic women. Depressive symptoms are common in women with prediabetes in early postpartum after GDM and are associated with a persistent worse metabolic profile, increased anxiety and lower quality of life postpartum. The mobile-based lifestyle intervention did not improve mental health.
为研究既往患有妊娠期糖尿病（GDM）且产后早期患有糖尿病前期的女性抑郁症状与代谢状况之间的关联，并探讨基于手机的生活方式干预是否会影响心理健康结局。对一项多中心随机对照试验（MELINDA）进行二次探索性分析，该试验评估了GDM后糖尿病前期女性基于手机的生活方式干预与标准随访（对照组）的效果。分析纳入了166名参与者，他们在基线（产后6 - 16周）和随机分组后一年完成了流行病学研究中心抑郁量表（CES - D）问卷[得分≥16提示（亚）临床抑郁]。一年时，26.5%的女性（n = 44）报告有抑郁症状，干预组和对照组之间无显著差异（30.5%对22.6%，P = 0.293）。有抑郁症状的女性（有症状女性）更年轻（30.9±4.9岁对32.5±3.8岁，P = 0.033），且高学历者较少（61.4%对80.3%，P = 0.028）。基线时，有症状女性代谢综合征发生率更高（38.6%对21.9%，P = 0.044），低密度脂蛋白胆固醇更高[3.2±0.8对2.8±0.8 mmol/L，P = 0.009]，生活质量更低（SF - 36评分更低，P < 0.050），且根据状态 - 特质焦虑问卷（STAI - 6）的焦虑水平更高（14.5±3.6对11.2±2.6，P < 0.001）。这些差异在产后一年持续存在，有症状女性的代谢状况更差、焦虑更多且生活质量更低。抑郁症状在GDM后产后早期患有糖尿病前期的女性中很常见，且与持续更差的代谢状况、产后焦虑增加和生活质量降低有关。基于手机的生活方式干预并未改善心理健康。
