Glucose Intolerance in Pregnancy and Postpartum Risk of Metabolic Syndrome in Young Women
Open Access
- 1 February 2010
- journal article
- other
- Published by The Endocrine Society in Journal of Clinical Endocrinology & Metabolism
- Vol. 95 (2), 670-677
- https://doi.org/10.1210/jc.2009-1990
Abstract
Context/Objective: Gestational diabetes mellitus (GDM) and even mild glucose intolerance in pregnancy are both associated with increased risks of developing type 2 diabetes and cardiovascular disease in the future. Because the metabolic syndrome also identifies patients at risk of type 2 diabetes and cardiovascular disease, we hypothesized that gestational dysglycemia may be associated with an unrecognized latent metabolic syndrome. Thus, we sought to evaluate the relationship between gestational glucose tolerance status and postpartum risk of metabolic syndrome. Design/Setting/Participants: In this prospective cohort study, 487 women underwent oral glucose tolerance testing in pregnancy and cardiometabolic characterization at 3 months postpartum. The antepartum testing defined three gestational glucose tolerance groups: GDM (n = 137); gestational impaired glucose tolerance (GIGT) (n = 91); and normal glucose tolerance (NGT) (n = 259). Main Outcome Measure: The primary outcome was the presence of the metabolic syndrome at 3 months postpartum, as defined by International Diabetes Federation (IDF) and American Heart Association/National Heart Lung and Blood Institute (AHA/NHLBI) criteria, respectively. Results: The postpartum prevalence of IDF metabolic syndrome progressively increased from NGT (10.0%) to GIGT (17.6%) to GDM (20.0%) (overall P = 0.016). The same progression was observed for AHA/NHLBI metabolic syndrome (NGT, 8.9%; GIGT, 15.4%; and GDM, 16.8%; overall P = 0.046). On logistic regression analysis, both GDM (odds ratio, 2.05; 95% confidence interval, 1.07–3.94) and GIGT (odds ratio, 2.16; 95% confidence interval, 1.05–4.42) independently predicted postpartum metabolic syndrome. Conclusions: Both GDM and mild glucose intolerance in pregnancy predict an increased likelihood of metabolic syndrome at 3 months postpartum, supporting the concept that women with gestational dysglycemia may have an underlying latent metabolic syndrome.Keywords
This publication has 34 references indexed in Scilit:
- A Multicenter, Randomized Trial of Treatment for Mild Gestational DiabetesThe New England Journal of Medicine, 2009
- Mild glucose intolerance in pregnancy and risk of cardiovascular disease: a population-based cohort studyCMAJ : Canadian Medical Association Journal, 2009
- An abnormal screening glucose challenge test in pregnancy predicts postpartum metabolic dysfunction, even when the antepartum oral glucose tolerance test is normalClinical Endocrinology, 2009
- Gestational diabetes: the need for a common groundThe Lancet, 2009
- The Antepartum Glucose Values that Predict Neonatal Macrosomia Differ from Those that Predict Postpartum Prediabetes or Diabetes: Implications for the Diagnostic Criteria for Gestational DiabetesJournal of Clinical Endocrinology & Metabolism, 2009
- Glucose Intolerance in Pregnancy and Future Risk of Pre-Diabetes or DiabetesDiabetes Care, 2008
- Increased Risk of Cardiovascular Disease in Young Women Following Gestational Diabetes MellitusDiabetes Care, 2008
- Risk of development of diabetes mellitus after diagnosis of gestational diabetesCMAJ : Canadian Medical Association Journal, 2008
- Isolated Hyperglycemia at 1 Hour on Oral Glucose Tolerance Test in Pregnancy Resembles Gestational Diabetes Mellitus in Predicting Postpartum Metabolic DysfunctionDiabetes Care, 2008
- Gestational Diabetes: Should It Be Added to the Syndrome of Insulin Resistance?Diabetes Care, 1997