Genetic Predisposition to Polycystic Ovary Syndrome, Postpartum Weight Reduction, and Glycemic Changes: A Longitudinal Study in Women With Prior Gestational Diabetes
Genetic Predisposition to Polycystic Ovary Syndrome, Postpartum Weight Reduction, and Glycemic Changes: A Longitudinal Study in Women With Prior Gestational Diabetes
复制标题
多囊卵巢综合症的遗传易感性、产后体重减轻和血糖变化：对既往患有妊娠期糖尿病的女性的纵向研究。
DOI：
10.1210/jc.2015-2664
复制
发表时间：
2015-12-01
影响因子：
5.8
通讯作者：
Qi, Lu
中科院分区：
文献类型：
--
作者：
Wang, Tiange;Leng, Junhong;Qi, Lu
背景：多囊卵巢综合征（PCOS）是育龄妇女的常见病，也是肥胖、糖耐量受损和糖尿病的主要女性特异性危险因素。目的：研究易患多囊卵巢综合征的遗传变异是否会影响妊娠期糖尿病（GDM）妇女的血糖变化，以及这种影响是否会随着身体脂肪的变化而改变，特别是在妊娠期间和妊娠后。设计、环境和参与者：这是一项在中国天津进行的纵向研究。我们对7项全基因组关联研究进行了基因分型，确定了PCOS单核苷酸多态性，并评估了1133名既往患有GDM的妇女妊娠期体重增加以及产后1至5年血糖特征和体重的变化。主要观察指标：主要观察指标为产后血糖变化。结果：经多变量调整后，PCOS遗传风险评分与产后体重减轻对空腹血糖和2小时血糖的变化有显著交互作用（交互作用P值分别为0.032和0.007）。在产后体重减轻5公斤/年的妇女中，遗传风险评分与空腹和2小时血糖降低有关，而在体重减轻较少的妇女中发现相反的遗传效应。产后体重减轻和血糖改善之间的关系在遗传风险评分较高的妇女中更为显著。结论：在一组有GDM病史的中国女性中，我们的数据首次表明PCOS的遗传易感性可能与产后体重减轻对长期血糖变化的相互作用，强调了产后体重管理对预防该亚组女性糖尿病的重要性。
Context: Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women and a major female-specific risk factor of obesity, impaired glucose tolerance, and diabetes.Objective: We examined whether the genetic variation predisposing to PCOS affected glycemic changes in women with prior gestational diabetes mellitus (GDM) and whether such an effect was modified by changes in body adiposity, especially during and after pregnancy.Design, Setting, and Participants: This is a longitudinal study in Tianjin, China. We genotyped 7 genome-wide association study-identified PCOS single nucleotide polymorphisms and assessed gestational weight gain and changes in glycemic traits and weight at 1 to 5 years postpartum in 1133 women with prior GDM.Main Outcome Measures: The main outcome measure was postpartum glycemic changes.Results: The PCOS genetic risk score significantly interacted with postpartum weight reduction on changes in fasting glucose and 2-h glucose (P for interaction = .032 and .007; respectively) after multivariable adjustment. In women with postpartum weight reduction of >= 5 kg/y, the genetic risk score was associated with decreased fasting and 2-h glucose, whereas an opposite genetic effect was found in women who lost less weight. The association between postpartum weight reduction and glycemic improvement was more significant among women with a higher genetic risk score.Conclusions: In a large cohort of Chinese women with a history of GDM, our data for the first time indicate that the genetic predisposition to PCOS may interact with postpartum weight reduction on long-term glycemic changes, emphasizing the importance of postpartum weight management in prevention of diabetes in this subgroup of women.