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 |
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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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