Long-Term Maternal Metabolic and Cardiovascular Phenotypes after a Pregnancy Complicated by Mild Gestational Diabetes Mellitus or Obesity

被引:0
|
作者
Battarbee, Ashley N. [1 ]
Mele, Lisa [2 ]
Landon, Mark B. [3 ]
Varner, Michael W. [4 ]
Casey, Brian M. [5 ]
Reddy, Uma M. [6 ]
Wapner, Ronald J. [7 ]
Rouse, Dwight J. [8 ]
Thorp, John M. [9 ]
Chien, Edward K. [10 ]
Saade, George [11 ]
Plunkett, Beth A. [12 ]
Blackwell, Sean C. [13 ]
机构
[1] Univ Alabama Birmingham, Dept Obstet & Gynecol, Div Maternal Fetal Med, 1700 6th Ave South,Room 10270, Birmingham, AL 35233 USA
[2] George Washington Univ, Biostat Ctr, Washington, DC USA
[3] Ohio State Univ, Coll Med, Dept Obstet & Gynecol, Columbus, OH 43210 USA
[4] Univ Utah, Hlth Sci Ctr, Dept Obstet & Gynecol, Salt Lake City, UT USA
[5] Univ Texas Southwestern Med Ctr Dallas, Dept Obstet & Gynecol, Dallas, TX USA
[6] Eunice Kennedy Shriver Natl Inst Child Hlth & Hum, Bethesda, MD USA
[7] Columbia Univ, Dept Obstet & Gynecol, New York, NY USA
[8] Brown Univ, Dept Obstet & Gynecol, Providence, RI 02912 USA
[9] Univ N Carolina, Dept Obstet & Gynecol, Chapel Hill, NC 27515 USA
[10] Case Western Reserve Univ, Metrohlth Med Ctr, Dept Obstet & Gynecol, Cleveland, OH USA
[11] Univ Texas Med Branch, Dept Obstet & Gynecol, Galveston, TX 77555 USA
[12] Northwestern Univ, Dept Obstet & Gynecol, Chicago, IL 60611 USA
[13] Univ Texas Hlth Sci Ctr Houston, Dept Obstet & Gynecol, Childrens Mem Hermann Hosp, Houston, TX 77030 USA
基金
美国国家卫生研究院;
关键词
cardiovascular disease; diabetes; gestational diabetes; obesity; pregnancy; INSULIN SENSITIVITY; DISEASE; HYPERTENSION; BIOMARKERS; WEIGHT; WOMEN; RISK;
D O I
10.1055/a-1970-7892
中图分类号
R71 [妇产科学];
学科分类号
100211 ;
摘要
Objective The aim of this study was to evaluate the association of mild gestational diabetes mellitus (GDM) and obesity with metabolic and cardiovascular markers 5 to 10 years after pregnancy.Study Design This was a secondary analysis of 5- to 10-year follow-up study of a mild GDM treatment trial and concurrent observational cohort of participants ineligible for the trial with abnormal 1-hour glucose challenge test only. Participants with 2-hour glucose tolerance test at follow-up were included. The primary exposures were mild GDM and obesity. The outcomes were insulinogenic index (IGI), 1/homeostatic model assessment of insulin resistance (HOMA-IR), and cardiovascular markers vascular endothelial growth factor, (VEGF), vascular cell adhesion molecule 1 (VCAM-1), cluster of differentiation 40 ligand (CD40L), growth differentiation factor 15 (GDF-15), and suppression of tumorgenesis 2 (ST-2). Multivariable linear regression estimated the association of GDM and obesity with biomarkers.Results Of 951 participants in the parent study, 642 (68%) were included. Lower 1/HOMA-IR were observed in treated and untreated GDM groups, compared with non-GDM (mean differences, -0.24 and -0.15; 95% confidence intervals [CIs], -0.36 to -0.12 and -0.28 to -0.03, respectively). Lower VCAM-1 (angiogenesis) was observed in treated GDM group (mean difference, -0.11; 95% CI, -0.19 to -0.03). GDM was not associated with IGI or other biomarkers. Obesity was associated with lower 1/HOMA-IR (mean difference, -0.42; 95% CI, -0.52 to -0.32), but not other biomarkers.Conclusion Prior GDM and obesity are associated with more insulin resistance but not insulin secretion or consistent cardiovascular dysfunction 5 to 10 years after delivery.
引用
收藏
页码:589 / 597
页数:9
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