Lifetime history of gestational diabetes and cognitive function in parous women in midlife.

Autor: Soria-Contreras DC; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA. dsoria@hsph.harvard.edu., Wang S; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Liu J; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Lawn RB; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Mitsunami M; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Purdue-Smithe AC; Division of Women's Health, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA., Zhang C; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Global Centre for Asian Women's Health, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.; Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore.; Bia-Echo Asia Centre for Reproductive Longevity & Equality, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore., Oken E; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA., Chavarro JE; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
Jazyk: angličtina
Zdroj: Diabetologia [Diabetologia] 2024 Sep 06. Date of Electronic Publication: 2024 Sep 06.
DOI: 10.1007/s00125-024-06270-w
Abstrakt: Aims/hypothesis: We aimed to determine whether a history of gestational diabetes mellitus (GDM) is associated with cognitive function in midlife.
Methods: We conducted a secondary data analysis of the prospective Nurses' Health Study II. From 1989 to 2001, and then in 2009, participants reported their history of GDM. A subset participated in a cognition sub-study in 2014-2019 (wave 1) or 2018-2022 (wave 2). We included 15,906 parous participants (≥1 birth at ≥18 years) who completed a cognitive assessment and were free of CVD, cancer and diabetes before their first birth. The primary exposure was a history of GDM. Additionally, we studied exposure to GDM and subsequent type 2 diabetes mellitus (neither GDM nor type 2 diabetes, GDM only, type 2 diabetes only or GDM followed by type 2 diabetes) and conducted mediation analysis by type 2 diabetes. The outcomes were composite z scores measuring psychomotor speed/attention, learning/working memory and global cognition obtained with the Cogstate brief battery. Mean differences (β and 95% CI) in cognitive function by GDM were estimated using linear regression.
Results: The 15,906 participants were a mean of 62.0 years (SD 4.9) at cognitive assessment, and 4.7% (n=749) had a history of GDM. In models adjusted for age at cognitive assessment, race and ethnicity, education, wave of enrolment in the cognition sub-study, socioeconomic status and pre-pregnancy characteristics, women with a history of GDM had lower performance in psychomotor speed/attention (β -0.08; 95% CI -0.14, -0.01) and global cognition (β -0.06; 95% CI -0.11, -0.01) than those without a history of GDM. The lower cognitive performance in women with GDM was only partially explained by the development of type 2 diabetes.
Conclusions/interpretation: Women with a history of GDM had poorer cognition than those without GDM. If replicated, our findings support future research on early risk modification strategies for women with a history of GDM as a potential avenue to decrease their risk of cognitive impairment.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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