Yuxin Fan1, Weiqin Li2, Huikun Liu2, Leishen Wang2, Shuang Zhang2, Wei Li2, Hongyan Liu2, Junhong Leng2, Yun Shen3, Jaakko Tuomilehto4, Zhijie Yu5, Xilin Yang6, Ming Liu7, Gang Hu8. 1. Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China; Pennington Biomedical Research Center, Baton Rouge, LA, USA. 2. Tianjin Women's and Children's Health Center, Tianjin, China. 3. Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Six People's Hospital, Shanghai, China. 4. Department of Public Health, University of Helsinki, Helsinki, Finland. 5. Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada. 6. Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China. 7. Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China. 8. Pennington Biomedical Research Center, Baton Rouge, LA, USA. Electronic address: gang.hu@pbrc.edu.
Abstract
OBJECTIVE: To evaluate the independent or combined effects of gestational diabetes (GDM) and pre-pregnancy and postpartum BMI on the odds of postpartum diabetes and hyperglycemia. METHODS: The study samples included 1263 women with prior GDM and 705 women without GDM. Postpartum 1-7 years diabetes was diagnosed by the standard oral glucose tolerance test. RESULTS: The multivariable-adjusted odds ratios among women with prior GDM, compared with those without it, were 7.52 for diabetes and 2.27 for hyperglycemia. The multivariable-adjusted odds ratios at different postpartum BMI levels (<24, 24-27.9, and ≥ 28 kg/m2) were 1.00, 2.80, and 8.08 for diabetes (Ptrend < 0.001), and 1.00, 2.10, and 4.42 for hyperglycemia (Ptrend < 0.001), respectively. Women with high body fat (≥31.9%) or abdominal obesity (≥85 cm) had a 2.7-6.9-fold higher odds ratio for diabetes or hyperglycemia. Women with both obesity and prior GDM had the highest risk of diabetes or hyperglycemia compared with non-obese women without GDM. Non-obese women with prior GDM had the same risk of diabetes and hyperglycemia as non-GDM women with obesity. When using Cox regression models, the results were very close to those using logistic regression models. CONCLUSIONS: Maternal prior GDM and pre-pregnancy or postpartum obesity contribute equally to postpartum diabetes and hyperglycemia risk.
OBJECTIVE: To evaluate the independent or combined effects of gestational diabetes (GDM) and pre-pregnancy and postpartum BMI on the odds of postpartum diabetes and hyperglycemia. METHODS: The study samples included 1263 women with prior GDM and 705 women without GDM. Postpartum 1-7 years diabetes was diagnosed by the standard oral glucose tolerance test. RESULTS: The multivariable-adjusted odds ratios among women with prior GDM, compared with those without it, were 7.52 for diabetes and 2.27 for hyperglycemia. The multivariable-adjusted odds ratios at different postpartum BMI levels (<24, 24-27.9, and ≥ 28 kg/m2) were 1.00, 2.80, and 8.08 for diabetes (Ptrend < 0.001), and 1.00, 2.10, and 4.42 for hyperglycemia (Ptrend < 0.001), respectively. Women with high body fat (≥31.9%) or abdominal obesity (≥85 cm) had a 2.7-6.9-fold higher odds ratio for diabetes or hyperglycemia. Women with both obesity and prior GDM had the highest risk of diabetes or hyperglycemia compared with non-obesewomen without GDM. Non-obesewomen with prior GDM had the same risk of diabetes and hyperglycemia as non-GDM women with obesity. When using Cox regression models, the results were very close to those using logistic regression models. CONCLUSIONS: Maternal prior GDM and pre-pregnancy or postpartum obesity contribute equally to postpartum diabetes and hyperglycemia risk.
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