Pregravid liver enzyme levels and risk of gestational diabetes mellitus during a subsequent pregnancy.
Pregravid liver enzyme levels and risk of gestational diabetes mellitus during a subsequent pregnancy.
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DOI：
10.2337/dc13-2229
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发表时间：
2014-07
期刊：
影响因子：
16.2
通讯作者：
Hedderson MM
中科院分区：
文献类型：
--
作者：
Sridhar SB;Xu F;Darbinian J;Quesenberry CP;Ferrara A;Hedderson MM
肝酶是2型糖尿病的独立预测因子。虽然肝脏脂肪含量与胰岛素抵抗的特征相关，胰岛素抵抗是发生妊娠期糖尿病（GDM）的危险因素，但肝酶与GDM之间的关系尚不清楚。本研究的目的是评估妊娠前肝酶水平是否与随后发生GDM的风险相关。在参加Kaiser Permanente北方加州多阶段健康检查（1984-1996）并随后怀孕（1984-2009）的妇女中进行了一项巢式病例对照研究。病例为256例GDM患者。为每个病例患者选择两名对照受试者，并匹配抽血年份、检查时年龄、妊娠时年龄和干预妊娠次数。γ-谷氨酰转移酶（GGT）水平处于最高四分位数与最低四分位数相比，在调整人种/种族、孕前BMI、糖尿病家族史和饮酒后，随后发生GDM的风险增加两倍（比值比1.97 [95%CI 1.14-3.42]）。在调整胰岛素抵抗（HOMA-IR）、空腹状态和妊娠体重增加率的稳态模型评估后，该结果减弱。GGT和HOMA-IR之间存在显著的相互作用，在HOMA-IR最高三分位数的妇女中发现与GGT相关。妊娠前谷氨酰转肽酶（GGT）水平，而不是谷丙转氨酶或谷草转氨酶水平，预测随后的GDM的风险。肝脏脂肪积累的标志物，如GGT水平，在怀孕前几年就存在，可能有助于识别随后GDM风险增加的女性。
Liver enzymes are independent predictors of type 2 diabetes. Although liver fat content correlates with features of insulin resistance, a risk factor for developing gestational diabetes mellitus (GDM), the relationship between liver enzymes and GDM is unclear. The objective of this study was to assess whether pregravid liver enzyme levels are associated with subsequent risk of GDM. A nested case-control study was conducted among women who participated in the Kaiser Permanente Northern California multiphasic health checkup (1984–1996) and had a subsequent pregnancy (1984–2009). Case patients were 256 women who developed GDM. Two control subjects were selected for each case patient and matched for year of blood draw, age at examination, age at pregnancy, and number of intervening pregnancies. Being in the highest quartile versus the lowest quartile of γ-glutamyl transferase (GGT) levels was associated with a twofold increased risk of subsequent GDM (odds ratio 1.97 [95% CI 1.14–3.42]), after adjusting for race/ethnicity, prepregnancy BMI, family history of diabetes, and alcohol use. This result was attenuated after adjusting for homeostasis model assessment of insulin resistance (HOMA-IR), fasting status, and rate of gestational weight gain. There was significant interaction between GGT and HOMA-IR; the association with GGT was found among women in the highest tertile of HOMA-IR. Aspartate aminotransferase and alanine aminotransferase were not associated with increased GDM risk. Pregravid GGT level, but not alanine aminotransferase or aspartate aminotransferase level, predicted the subsequent risk of GDM. Markers of liver fat accumulation, such as GGT level, are present years before pregnancy and may help to identify women at increased risk for subsequent GDM.
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影响因子：
3.5
作者：
Gao Fei;Pan Jie Min;Jia Wei Ping
通讯作者：
Jia Wei Ping
影响因子：
7.2
作者：
Ferrara, A;Kahn, HS;Hedderson, MM
通讯作者：
Hedderson, MM
影响因子：
7.2
作者：
通讯作者：
--
影响因子：
16.2
作者：
Perry, IJ;Wannamethee, SG;Shaper, AG
通讯作者：
Shaper, AG
影响因子：
8.2
作者：
Lee, D. -H.;Steffes, M. W.;Jacobs, D. R., Jr.
通讯作者：
Jacobs, D. R., Jr.