Emilia Huvinen1,2, Johan G Eriksson3,4,5, Saila B Koivusalo6, Nora Grotenfelt3,4, Aila Tiitinen6, Beata Stach-Lempinen7, Kristiina Rönö6. 1. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. emilia.huvinen@helsinki.fi. 2. Department of General Practice and Primary Health Care, Biomedicum Helsinki, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland. emilia.huvinen@helsinki.fi. 3. Department of General Practice and Primary Health Care, Biomedicum Helsinki, University of Helsinki, Tukholmankatu 8 B, P.O. Box 20, 00014, Helsinki, Finland. 4. Folkhälsan Research Center, Helsinki, Finland. 5. Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland. 6. Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 7. Department of Obstetrics and Gynecology, South Karelia Central Hospital, Lappeenranta, Finland.
Abstract
AIMS: To assess the metabolic health of obese and non-obese women at high GDM risk 5 years postpartum. METHODS: This is a secondary analysis of the 5-year follow-up of the RADIEL GDM prevention study including 333 women at high GDM risk (BMI ≥ 30 kg/m2 and/or previous GDM). Five years postpartum metabolic health was assessed including anthropometric measurements, oral glucose tolerance test, lipid metabolism, and body composition as well as medical history questionnaires. For the analysis, we divided the women into four groups based on parity, BMI, and previous history of GDM. RESULTS: Five years postpartum impaired glucose regulation (IFG, IGT, or diabetes) was diagnosed in 15% of the women; 3.6% had type 2 diabetes. The highest prevalence was observed among obese women with a history of GDM (26%), and the lowest prevalence (8%) among primiparous obese women (p = 0.021). At follow-up 25-39% of the obese women fulfilled the diagnostic criteria for the metabolic syndrome, in the non-obese group 11% (p < 0.001). This was associated with body fat percentage. The non-obese group, however, faced metabolic disturbances (IFG, IGT, diabetes, or metabolic syndrome) at a significantly lower BMI (p < 0.001). Among women who were non-obese before pregnancy, 5 years postpartum, the obesity prevalence based on BMI was 14% and based on body fat percentage 58%. CONCLUSIONS: The prevalence of impaired glucose regulation and metabolic syndrome is high 5 years postpartum among women at high risk of GDM. There are high-risk women also among the non-obese, who develop metabolic derangements already at a lower BMI. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.com , NCT01698385.
AIMS: To assess the metabolic health of obese and non-obesewomen at high GDM risk 5 years postpartum. METHODS: This is a secondary analysis of the 5-year follow-up of the RADIEL GDM prevention study including 333 women at high GDM risk (BMI ≥ 30 kg/m2 and/or previous GDM). Five years postpartum metabolic health was assessed including anthropometric measurements, oral glucose tolerance test, lipid metabolism, and body composition as well as medical history questionnaires. For the analysis, we divided the women into four groups based on parity, BMI, and previous history of GDM. RESULTS: Five years postpartum impaired glucose regulation (IFG, IGT, or diabetes) was diagnosed in 15% of the women; 3.6% had type 2 diabetes. The highest prevalence was observed among obesewomen with a history of GDM (26%), and the lowest prevalence (8%) among primiparous obesewomen (p = 0.021). At follow-up 25-39% of the obesewomen fulfilled the diagnostic criteria for the metabolic syndrome, in the non-obese group 11% (p < 0.001). This was associated with body fat percentage. The non-obese group, however, faced metabolic disturbances (IFG, IGT, diabetes, or metabolic syndrome) at a significantly lower BMI (p < 0.001). Among women who were non-obese before pregnancy, 5 years postpartum, the obesity prevalence based on BMI was 14% and based on body fat percentage 58%. CONCLUSIONS: The prevalence of impaired glucose regulation and metabolic syndrome is high 5 years postpartum among women at high risk of GDM. There are high-risk women also among the non-obese, who develop metabolic derangements already at a lower BMI. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, www.clinicaltrials.com , NCT01698385.
Entities:
Keywords:
Body composition; Gestational diabetes; Heterogeneity; Metabolic syndrome; Normal weight obesity; Type 2 diabetes
Authors: Katrien Benhalima; Paul Van Crombrugge; Carolien Moyson; Johan Verhaeghe; Sofie Vandeginste; Hilde Verlaenen; Chris Vercammen; Toon Maes; Els Dufraimont; Christophe De Block; Yves Jacquemyn; Farah Mekahli; Katrien De Clippel; Annick Van Den Bruel; Anne Loccufier; Annouschka Laenen; Caro Minschart; Roland Devlieger; Chantal Mathieu Journal: Acta Diabetol Date: 2020-01-08 Impact factor: 4.280
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