Metabolic syndrome at follow-up in women with and without gestational diabetes mellitus in index pregnancy
Metabolic syndrome at follow-up in women with and without gestational diabetes mellitus in index pregnancy
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DOI：
10.1016/j.metabol.2005.03.017
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发表时间：
2005-08-01
影响因子：
9.8
通讯作者：
Corcoy, R
中科院分区：
文献类型：
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作者：
Albareda, M;Caballero, A;Corcoy, R
我们前瞻性地研究了262名既往患有妊娠期糖尿病(GDM)的妇女和66名对照妇女，以比较她们代谢综合征的患病率及其与胰岛素分泌和敏感性的关系。75克口服葡萄糖耐量试验计划在产后5年进行，同时进行血脂、人体测量学和血压测量。代谢综合征的定义根据2001年国家胆固醇教育计划，胰岛素敏感性和分泌采用稳态模型评估。有妊娠期糖尿病史的妇女与对照组妇女相比，对胰岛素的敏感性相似，但胰岛素分泌较低。与对照妇女相比，有妊娠期糖尿病史的妇女有更高的血压、腰围、极低密度脂蛋白胆固醇和口服葡萄糖耐量试验血糖值，但除空腹高血糖外，代谢综合征或其组成部分的患病率并未增加。代谢综合征及其组成部分的多变量预测与年龄和当前的稳态模型评估-胰岛素分泌和抵抗指数或年龄、肥胖和妊娠期糖尿病相似。第一个病例的主要预测因子是当前的胰岛素抵抗，第二个病例是肥胖，总体上肥胖是最好的预测因子。我们的结论是，在我们的人群中，在中期随访中，有妊娠期糖尿病史的女性胰岛素分泌减少，表现出更高的空腹高血糖患病率，但并不是代谢综合征的全貌。肥胖是胰岛素抵抗的一个替代指标，是后续代谢综合征的最佳预测指标。(C)2005 Elsevier Inc.保留所有权利。
We prospectively studied 262 women with prior gestational diabetes mellitus (GDM) and 66 control women to compare their prevalence of metabolic syndrome and its relationship with insulin secretion and sensitivity. A 75-g oral glucose tolerance test was scheduled 5 years after delivery along with lipid profile, anthropometrics, and blood pressure measurement. Metabolic syndrome was defined according to the National Cholesterol Education Program 2001, and insulin sensitivity and secretion were estimated with the homeostasis model assessment. Women with prior GDM had similar insulin sensitivity and lower insulin secretion than control women. In comparison with control women, women with prior GDM had higher blood pressure, waist circumference, very low-density lipoprotein cholesterol, and oral glucose tolerance test blood glucose values but, with the exception of fasting hyperglycemia, did not have an increased prevalence of metabolic syndrome or its components. The multivariate prediction of metabolic syndrome and its components was similar with age and current homeostasis model assessment-insulin secretion and resistance indexes or with age, obesity, and GDM. The main predictor was current insulin resistance in the first case and obesity in the second, obesity being the best predictor overall. We conclude that in our population and at midterm follow-up, women with prior GDM have a decreased insulin secretion and display a higher prevalence of fasting hyperglycemia but not the full-blown picture of metabolic syndrome. Obesity, a surrogate index of insulin resistance, is the best predictor of metabolic syndrome at follow-up. (C) 2005 Elsevier Inc. All rights reserved.