Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis

Pathirana, Maleesa M.; Lassi, Zohra S; Alı̀, Anna; Arstall, Margaret A.; Roberts, Claire T.; Andraweera, Prabha H.

doi:10.1007/s11154-020-09587-0

Cited by 34 publications

(35 citation statements)

References 158 publications

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“…In addition, women who developed gestational hyperglycemia were reported to have adverse cardiovascular risk profiles even in the years before pregnancy. 36 It was demonstrated in a meta-analysis that women with gestational diabetes have increased CVD risk factors, including BMI, TC, TG, LDL, glucose, insulin, and blood pressure, 37 which are the basis for the future CVD events. Besides, women with history of gestational hyperglycemia tend to have poor vascular adaptation and endothelial dysfunction, 38,39 which may partly explain the increased risk of CVD.…”

Section: Discussionmentioning

confidence: 99%

Gestational hyperglycemia and the risk of cardiovascular diseases among elderly Chinese women: Findings from the REACTION study

Zeng

Lin

et al. 2021

Journal of Diabetes

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Background: Gestational hyperglycemia increases the risk of diabetes in later life. However, the risk of future cardiovascular diseases (CVD) related to gestational hyperglycemia remains inconclusive. The purpose of this study was to investigate the impact of gestational hyperglycemia on the subsequent risk of CVD and its modifying factors among elderly Chinese women.Methods: We conducted a case-control study of elderly women from the baseline survey of Risk Evaluation of cAncers in Chinese diabeTic Individuals: a lONgitudinal (REACTION) study. Women with gestational hyperglycemia (n = 82), and controls matched by age and study site (n = 410) were included. Information on CVD, including reported coronary heart disease, stroke, or myocardial infarction, was collected through an interviewer-assisted questionnaire.Results: Women with gestational hyperglycemia were more likely to develop diabetes (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.50-4.18) and CVD (OR, 1.98; 95% CI, 1.05-3.74). Even without progressing to type 2 diabetes, gestational hyperglycemia was associated with an increased risk of CVD (OR, 2.88; 95% CI, 1.18-7.00). However, subgroup analysis indicated that compared with those without gestational hyperglycemia or hypertension, women with both gestational hyperglycemia and hypertension had higher risk of CVD (OR, 3.98; 95% CI, 1.65-9.58), whereas the risk estimate did not significantly change in women with gestational hyperglycemia alone (OR, 2.15; 95% CI, 0.71-6.57). Stratified analysis indicated that among those with overweight/obesity, inactive physical activity, or unhealthy dietary habits, gestational hyperglycemia increased the risk of CVD. Conclusions:In elderly Chinese women, gestational hyperglycemia was associated with an increased risk of CVD in later life. This association was independent of the progression to diabetes and might be modified by lifestyle factors and hypertension.

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Section: Discussionmentioning

confidence: 99%

Gestational hyperglycemia and the risk of cardiovascular diseases among elderly Chinese women: Findings from the REACTION study

Zeng

Lin

et al. 2021

Journal of Diabetes

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“…Second, in addition to diabetes, obesity, hypertension and metabolic syndrome are also risk factors for stone formation ( 7 ). Results from a recent review suggested that women with previous GDM have significantly higher blood pressure, body mass index, total cholesterol, LDL cholesterol, triglycerides, glucose and significantly lower HDL cholesterol ( 10 ). In this analysis, women with previous GDM also had significantly higher prevalence of obesity, diabetes and metabolic syndrome, while had significantly lower prevalence of hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…GDM increases the risk of long-term complications including diabetes ( 8 , 9 ), cardiovascular diseases ( 10 , 11 ), metabolic syndromes ( 12 ) and cancer ( 13 ). However, the association between previous GDM and risk of kidney stones has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Association Between Gestational Diabetes Mellitus and Future Risk of Kidney Stones

Mao

Hu²,

Liu

et al. 2022

Front. Public Health

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ObjectiveThe association between history of gestational diabetes mellitus (GDM) and risk of kidney stones has not been reported. GDM increases the risk of long-term complications including diabetes, hypertension and metabolic syndrome, which are risk factors of kidney stones. This study aimed to explore the association between previous GDM and odds of kidney stones.MethodsWomen (age ≥ 20 years) who had delivered at least one live birth were included from the 2007–2018 National Health and Nutrition Examination Survey cohort (N = 12,003). Patients with kidney stones and history of GDM were identified by in-home interview for all participants. Subgroup analyses were conducted by age, race/ethnicity, postpartum duration and status of hypertension, obesity, current diabetes and metabolic syndrome.ResultsPrevious GDM was positively associated with odds of kidney stones [multivariate-adjusted odds ratio (95% confidence interval): 1.41 (1.13–1.77)], and the association was stronger with odds of passing 2 or more times of kidney stones [1.72 (1.31–2.26)]. In subgroup analyses, the association between previous GDM and odds of kidney stones was significant in women within 15 years of a pregnancy complicated by GDM [1.54 (1.12–2.11)], in obese participants [1.56 (1.18–2.06)], in women without hypertension [1.49 (1.07–2.08)], current diabetes [1.38 (1.02–1.87)] and metabolic syndrome [1.56 (1.10–2.19)], in women of Non-Hispanic White [1.59 (1.15–2.18)] and in women aged more than 50 year [1.45 (1.02–2.07)].ConclusionsPrevious GDM was positively associated with odds of kidney stones, and the association was independent of type 2 diabetes, hypertension and metabolic syndrome.

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“…This suggests that women with eGDM and RFs already have pre-existing impaired glucose tolerance before pregnancy (47,48). It has also been suggested that (pre-existing) dysregulation of cytokines and the increase in free fatty acids in GDM promotes metabolic dysfunction, which might be more pronounced in eGDM (49). In our cohort, women diagnosed with eGDM did not only have a higher FPG, but A c c e p t e d M a n u s c r i p t 15 also higher HbA1c values at baseline than those diagnosed with cGDM.…”

Section: Discussionmentioning

confidence: 99%

Cardiometabolic and Mental Health in Women With Early Gestational Diabetes Mellitus: A Prospective Cohort Study

Quansah

Gross

Gilbert

et al. 2021

The Journal of Clinical Endocrinology &Amp; Metabolism

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Context Early diagnosis and treatment of gestational diabetes (GDM) may reduce adverse obstetric and neonatal outcomes, especially in high-risk women. However, there is a lack of data for other outcomes. Objective We compared cardiometabolic and mental health outcomes in women with early (eGDM) and classical (cGDM) GDM. Methods This prospective cohort included 1185 All women with cGDM and 76 women with eGDM. The eGDM group had GDM risk factors (BMI >30 kg/m2, family history of diabetes, history of GDM, ethnicity), were tested at <20 weeks gestational age, and diagnosed using American Diabetes Association prediabetes criteria. All women underwent lifestyle adaptations. Obstetric, neonatal, mental, and cardiometabolic outcomes were assessed during pregnancy and postpartum. Results The eGDM group had lower gestational weight gain than cGDM (10.7 ± 6.2 vs 12.6 ± 6.4; P = 0.03) but needed more medical treatment (66% vs 42%; P < 0.001). They had similar rates of adverse maternal and neonatal outcomes, except for increased large-for-gestational-age infants (25% vs 15%; P = 0.02). Mental health during pregnancy and postpartum did not differ between groups. eGDM had more atherogenic postpartum lipid profile than cGDM (P ≤ 0.001). In eGDM, the postpartum prevalence of the metabolic syndrome (MetS) was 1.8-fold, prediabetes was 3.1-fold, and diabetes was 7.4-fold higher than cGDM (waist circumference-based MetS: 62% vs 34%/BMI-based MetS: 46% vs 24%; prediabetes: 47.5% vs 15.3%; diabetes: 11.9% vs 1.6%, all P < 0.001). These differences remained unchanged after adjusting for GDM risk factors. Conclusion Compared with cGDM, eGDM was not associated with differences in mental health, but with increased adverse cardiometabolic outcomes, independent of GDM risk factors and gestational weight gain. This hints to a preexisting risk profile in eGDM.

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Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis

Cited by 34 publications

References 158 publications

Gestational hyperglycemia and the risk of cardiovascular diseases among elderly Chinese women: Findings from the REACTION study

Gestational hyperglycemia and the risk of cardiovascular diseases among elderly Chinese women: Findings from the REACTION study

Association Between Gestational Diabetes Mellitus and Future Risk of Kidney Stones

Cardiometabolic and Mental Health in Women With Early Gestational Diabetes Mellitus: A Prospective Cohort Study

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