Cardiovascular disease risk profiles in women with histories of gestational diabetes but without current diabetes.
Cardiovascular disease risk profiles in women with histories of gestational diabetes but without current diabetes.
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DOI：
10.1097/aog.0b013e31818638b5
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发表时间：
2008-10
影响因子：
7.2
通讯作者：
Beckles GL
中科院分区：
文献类型：
--
作者：
Kim C;Cheng YJ;Beckles GL
比较有妊娠糖尿病史但未患糖尿病的产妇、诊断为糖尿病的产妇和无糖尿病的产妇的心血管疾病危险因素。我们在第三次全国健康和营养检查调查（1988-1994）中对4,631名目前未怀孕的产妇进行了横断面分析。根据自我报告，有妊娠糖尿病史但目前未患糖尿病的妇女（n=85），诊断为糖尿病的妇女（n=218），或无糖尿病的妇女（n= 4328）。我们比较了这些组的胆固醇亚型、血压、尿酸、微量白蛋白尿、胰岛素和葡萄糖，以及在调整人口统计学、行为因素和中枢性肥胖之前和之后的危险因素聚类。在未经调整的比较中，有妊娠糖尿病史但目前未患糖尿病的妇女与未受影响的妇女相比具有更有利或相似的危险因素，但有两个例外：更高的平均空腹血糖水平（94.0 mg/dl对106.8 mg/dl, p<0.001）和平均空腹胰岛素水平（10.2 IU/l对14.0 IU/l, p<0.001）。在调整了人口统计学因素和腰围后，这些模式减弱了，但在空腹血糖和尿微量白蛋白/肌酐比值方面仍然显著。在调整前后，诊断为糖尿病的产妇患心血管疾病的风险显著低于未受影响的妇女。除了胰岛素和血糖水平外，有妊娠糖尿病史但目前未患糖尿病的妇女与未患糖尿病的妇女有相似的心血管疾病风险。
To compare the cardiovascular disease risk factor profiles of parous women with a history of gestational diabetes who had not developed diabetes, parous women with diagnosed diabetes, and parous women with neither condition. We conducted cross-sectional analyses of 4,631 parous women who were not currently pregnant in the Third National Health and Nutrition Examination Survey (1988-1994). Women were classified by self-report as having a history of gestational diabetes who were not currently diabetic (n=85), diagnosed diabetics (n=218), or as having neither condition (n=4,328). We compared these groups with respect to cholesterol subtypes, blood pressure, uric acid, microalbuminuria, insulin, and glucose, and clustering of risk factors, before and after adjustment for demographic and behavioral factors and central obesity. In unadjusted comparisons, women who had a history of gestational diabetes who were not currently diabetics had a more favorable or similar risk factor profile compared to unaffected women, with two exceptions: greater levels of mean fasting glucose (94.0 mg/dl vs. 106.8 mg/dl, p<0.001) and mean fasting insulin (10.2 IU/l vs. 14.0 IU/l, p<0.001). These patterns were attenuated after adjustment for demographic factors and waist circumference, but remained significant for fasting glucose and the ratio of urine microalbumin/creatinine. Parous women with diagnosed diabetes had significantly worse cardiovascular disease risk profiles than unaffected women before and after adjustment. Women who had a history of gestational diabetes who were not currently diabetics have a similar cardiovascular disease risk profile to unaffected women, with the exception of insulin and glucose levels.