Meyers-Seifer C H, Vohr B R
Department of Pediatrics, Rhode Island Hospital, Providence, USA.
Diabetes Care. 1996 Dec;19(12):1351-6. doi: 10.2337/diacare.19.12.1351.
To investigate lipid levels in former gestational diabetic mothers, 5-6 years postpartum, and to evaluate the relationship of these values to glucose, insulin, BMI, and blood pressure.
The subjects studied were 56 former gestational diabetic mothers and 48 control mothers 5-6 years postpartum. Two hours after a 50-g carbohydrate meal, total cholesterol (TC), triglycerides (TG), HDL and LDL cholesterol, glucose, and insulin were measured and compared between the two groups (analysis of variance). BMI and blood pressure were also evaluated. The risk of finding an abnormal metabolic, anthropometric, or hemodynamic parameter in either group was assessed (chi 2 analysis and Fisher's exact test). Correlation coefficients were assessed between the lipids versus insulin, glucose, BMI, and blood pressure.
Mean TC, TG, LDL cholesterol, glucose, and systolic blood pressure were significantly higher in the gestational diabetic mothers than in the control mothers. In addition, there was greater likelihood of finding an abnormal TC > or = 5.17 mmol/l, LDL cholesterol > or = 4.14 mmol/l, and systolic blood pressure > 140 mmHg in gestational diabetic mothers. Triglycerides correlated with BMI, insulin, systolic and diastolic blood pressure, and HDL cholesterol correlated inversely with insulin in gestational diabetic mothers.
We conclude that at 5-6 years postpartum, former gestational diabetic mothers demonstrate changes in lipid levels that differ from control mothers and that specific lipids correlate with cardiovascular risk factors. Further study is needed to evaluate gestational diabetic mothers for the development of cardiovascular risk factors including insulin resistance.
调查既往妊娠糖尿病母亲产后5 - 6年的血脂水平，并评估这些值与血糖、胰岛素、体重指数（BMI）和血压的关系。
研究对象为56名既往妊娠糖尿病母亲和48名产后5 - 6年的对照母亲。给予50克碳水化合物餐后两小时，测量两组的总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）胆固醇、血糖和胰岛素水平并进行比较（方差分析）。同时评估BMI和血压。评估两组中出现异常代谢、人体测量或血流动力学参数的风险（卡方分析和Fisher精确检验）。评估血脂与胰岛素、血糖、BMI和血压之间的相关系数。
妊娠糖尿病母亲的平均TC、TG、LDL胆固醇、血糖和收缩压显著高于对照母亲。此外，妊娠糖尿病母亲中TC≥5.17 mmol/l、LDL胆固醇≥4.14 mmol/l和收缩压>140 mmHg的异常发生率更高。在妊娠糖尿病母亲中，甘油三酯与BMI、胰岛素、收缩压和舒张压相关，而HDL胆固醇与胰岛素呈负相关。
我们得出结论，产后5 - 6年，既往妊娠糖尿病母亲的血脂水平变化与对照母亲不同，且特定血脂与心血管危险因素相关。需要进一步研究以评估妊娠糖尿病母亲心血管危险因素（包括胰岛素抵抗）的发展情况。
