Jang H C, Min H K, Lee H K, Cho N H, Metzger B E
Department of Medicine, Samsung Cheil Hospital, College of Medicine, Sung Kyun Kwan University, Seoul, Korea.
Diabetologia. 1998 Jul;41(7):778-83. doi: 10.1007/s001250050987.
We examined the associations between demographic characteristics including short stature and the prevalence of gestational diabetes mellitus (GDM) in Korean women. In this study, a total of 9005 pregnant women underwent universal screening for GDM. Oral glucose tolerance tests (100 g OGTT) were performed in positive screenees (1 h plasma glucose > or = 7.2 mmol/l) and GDM was diagnosed using National Diabetes Data Group criteria. Women with GDM were older and heavier than those with a positive screen and normal OGTT, as well as those with a negative screen. However, height of women with GDM was significantly shorter than those with a positive screen and normal OGTT, and a negative screen. When the study subjects were stratified according to height quartiles, the plasma glucose at the screening test decreased as height increased. Furthermore, the prevalence of GDM was highest in the shortest quartile (< or = 157 cm) group; the odds ratio for GDM was two times greater compared with the highest quartile (> or = 163 cm) group, even after controlling for age and body mass index (BMI). In addition, multiple logistic regression analysis revealed that greater prepregnancy BMI, age, weight gain, a parental history of diabetes mellitus, and shorter maternal height were directly and independently associated with the prevalence of GDM. We have found that short stature is an independent risk factor for GDM in the racially homogeneous population of Seoul, Korea. It is suggested that this propensity may be conveyed primarily by environmental influences. However, genetic factors may also modify the response to the environmental insult. Our findings also emphasize the heterogeneity of factors which predispose to GDM.
我们研究了包括身材矮小在内的人口统计学特征与韩国女性妊娠期糖尿病（GDM）患病率之间的关联。在本研究中，共有9005名孕妇接受了GDM的普遍筛查。对筛查呈阳性者（1小时血浆葡萄糖≥7.2 mmol/l）进行口服葡萄糖耐量试验（100 g口服葡萄糖耐量试验），并使用美国国家糖尿病数据组标准诊断GDM。患有GDM的女性比筛查呈阳性且口服葡萄糖耐量试验正常的女性以及筛查呈阴性的女性年龄更大、体重更重。然而，患有GDM的女性身高显著低于筛查呈阳性且口服葡萄糖耐量试验正常的女性以及筛查呈阴性的女性。当根据身高四分位数对研究对象进行分层时，筛查试验时的血浆葡萄糖水平随身高增加而降低。此外，GDM患病率在最矮四分位数（≤157 cm）组中最高；即使在控制年龄和体重指数（BMI）后，GDM的优势比与最高四分位数（≥163 cm）组相比仍高出两倍。此外，多因素逻辑回归分析显示，孕前BMI更高、年龄更大、体重增加、糖尿病家族史以及母亲身高更矮与GDM患病率直接且独立相关。我们发现，在韩国首尔种族同质的人群中，身材矮小是GDM的一个独立危险因素。提示这种倾向可能主要由环境影响所致。然而，遗传因素也可能改变对环境损害的反应。我们的研究结果还强调了易患GDM的因素的异质性。
