Gestational Diabetes Mellitus and the Risks of Overall and Type-Specific Cardiovascular Diseases: A Population- and Sibling-Matched Cohort Study

Autor: Yongfu Yu, Onyebuchi A. Arah, Henrik Toft Sørensen, Jiong Li, Melissa Soohoo
Rok vydání: 2022
Předmět:
medicine.medical_specialty
Aging
Endocrinology
Diabetes and Metabolism
Population
Type 2 diabetes
Disease
Cardiovascular
Medical and Health Sciences
Cohort Studies
Endocrinology & Metabolism
Risk Factors
Pregnancy
Clinical Research
Diabetes mellitus
Internal Medicine
medicine
Diabetes Mellitus
Humans
Obesity
Epidemiology/Health Services Research
education
Metabolic and endocrine
Nutrition
Advanced and Specialized Nursing
Pediatric
education.field_of_study
business.industry
Proportional hazards model
Obstetrics
Cardiovascular Diseases/epidemiology
Diabetes Mellitus
Type 2/complications
Siblings
Prevention
Hazard ratio
Diabetes
Perinatal Period - Conditions Originating in Perinatal Period
medicine.disease
Gestational diabetes
Diabetes
Gestational
Heart Disease
Good Health and Well Being
Diabetes Mellitus
Type 2
Cardiovascular Diseases
Gestational
Female
Diabetes
Gestational/epidemiology
business
Type 2
Cohort study
Zdroj: Diabetes care, vol 45, iss 1
Yu, Y, Soohoo, M, Sørensen, H T, Li, J & Arah, O A 2022, ' Gestational Diabetes Mellitus and the Risks of Overall and Type-Specific Cardiovascular Diseases : A Population-and Sibling-Matched Cohort Study ', Diabetes Care, vol. 45, no. 1, pp. 151-159 . https://doi.org/10.2337/dc21-1018
Diabetes Care
Popis: OBJECTIVE To evaluate associations between gestational diabetes mellitus (GDM) and various incident cardiovascular disease (CVD) end points, considering the effects of the mediating role of type 2 diabetes and shared environmental/familial factors. RESEARCH DESIGN AND METHODS This population-based cohort study included 10,02,486 parous women in Denmark during 1978–2016. We used Cox regression to 1) examine the associations of GDM with overall and type-specific CVDs using full-cohort and sibling-matched analysis, 2) quantify the impact of type 2 diabetes after GDM using mediation analysis, and 3) assess whether these associations were modified by prepregnancy obesity or maternal history of CVD. RESULTS Women with a history of GDM had a 40% increased overall CVD risk (hazard ratio [HR] 1.40, 95% CI 1.35–1.45). Sibling-matched analyses yielded similar results (HR 1.44, 95% CI 1.28–1.62). The proportion of association between GDM and overall CVD explained by subsequent type 2 diabetes was 23.3% (15.4–32.8%). We observed increased risks of specific CVDs, including 65% increased stroke risk and more than twofold risks for myocardial infarction, heart failure, and peripheral artery disease. The elevated overall risks were more pronounced among women with GDM and prepregnancy obesity or maternal history of CVD. CONCLUSIONS A history of GDM was associated with increased risks of overall and specific CVDs. Increased risks were partly explained by subsequent type 2 diabetes, and the need to identify other pathways remains important. Continuous monitoring of women with a history of GDM, especially those with prepregnancy obesity or maternal history of CVD, may provide better opportunities to reduce their cardiovascular risk.
Databáze: OpenAIRE
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