Glucose tolerance and risk of gestational diabetes mellitus in nulliparous women who smoke during pregnancy
Glucose tolerance and risk of gestational diabetes mellitus in nulliparous women who smoke during pregnancy
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DOI：
10.1093/aje/kwh340
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发表时间：
2004-12-15
影响因子：
5
通讯作者：
Catalano, PM
中科院分区：
文献类型：
--
作者：
England, LJ;Levine, RJ;Catalano, PM
妊娠期糖尿病与不良母婴结局相关，包括先兆子痫和巨大儿。虽然吸烟与胰岛素抵抗增加有关，但其对妊娠糖尿病风险的影响尚不确定。作者评估了吸烟对一组孕妇葡萄糖耐量的影响，这些孕妇参加了钙预防先兆子痫试验，这是一项1992年至1995年在美国五个医疗中心进行的对未经产妇女的随机研究。分析妊娠期糖尿病筛查和诊断试验的结果。在4,589名入组的妇女中，有3,774名妇女可获得50 g口服葡萄糖挑战后1小时的血糖浓度和妊娠结局的完整信息;有3,602名妇女已知妊娠期糖尿病状态。与从不吸烟的女性相比，研究入组时吸烟的女性校正后的平均1小时血糖浓度（mg/dl）升高（112.6，95%置信区间：110.0，115.3）（108.3，95%置信区间：106.7，109.8; p < 0.01）。当使用国家糖尿病数据组提出的标准时，吸烟的妇女患妊娠糖尿病的风险增加（校正比值比= 1.9，95%置信区间：1.0，3.6）。这些发现支持吸烟与妊娠期糖尿病之间的关联。
Gestational diabetes mellitus has been associated with adverse maternal and infant outcomes, including preeclampsia and fetal macrosomia. Although cigarette smoking has been associated with increased insulin resistance, its effect on gestational diabetes mellitus risk is uncertain. The authors evaluated the effects of smoking on glucose tolerance in a cohort of pregnant women who participated in the Calcium for Preeclampsia Prevention trial, a randomized study of nulliparous women conducted in five US medical centers from 1992 to 1995. Results of screening and diagnostic testing for gestational diabetes mellitus were analyzed. For 3,774 of the 4,589 women enrolled, plasma glucose concentration 1 hour after a 50-g oral glucose challenge and complete information on pregnancy outcome were available; for 3,602 of the women, gestational diabetes mellitus status was known. Adjusted mean 1-hour plasma glucose concentration (mg/dl) was elevated in women who smoked at study enrollment (112.6, 95% confidence interval: 110.0, 115.3) compared with women who had never smoked (108.3, 95% confidence interval: 106.7, 109.8; p < 0.01). Women who smoked were at increased risk of gestational diabetes mellitus when criteria proposed by the National Diabetes Data Group were used (adjusted odds ratio = 1.9, 95% confidence interval: 1.0, 3.6). These findings support an association between smoking and gestational diabetes mellitus.