Obesity index and the risk of diabetes among Chinese women with prior gestational diabetes

Wang, L.; Liu, H.; Zhang, S.; Leng, Junhong; Liu, G.; Zhang, C.; Li, W. Q.; Li, N.; Li, W.; Li, Y.; Sun, Shurong; Yu, Zhijie; Yang, Xilin; Hu, Gang

doi:10.1111/dme.12532

Cited by 31 publications

(31 citation statements)

References 28 publications

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“…Further prospective data on women meeting IADPSG criteria only will be useful in clarifying this issue. The factors associated with progression to abnormal glucose tolerance are similar to those noted in previous studies using older criteria -pregnancy OGTT values (fasting glucose in particular) (16,21,22,23,24) and elevated BMI after pregnancy (25,26). Earlier diagnosis of GDM, noted in previous studies as a risk factor (22,24,27,28,29,30), is associated with abnormal glucose tolerance at the first post-partum visit, but not with later progression.…”

Section: Discussionsupporting

confidence: 83%

Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria

Noctor

Crowe

Carmody

et al. 2016

European Journal of Endocrinology

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Objective: An increase in gestational diabetes mellitus (GDM) prevalence has been demonstrated across many countries with adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Here, we determine the cumulative incidence of abnormal glucose tolerance among women with previous GDM, and identify clinical risk factors predicting this. Design: Two hundred and seventy women with previous IADPSG-defined GDM were prospectively followed up for 5 years (mean 2.6) post-index pregnancy, and compared with 388 women with normal glucose tolerance (NGT) in pregnancy. Methods: Cumulative incidence of abnormal glucose tolerance (using American Diabetes Association criteria for impaired fasting glucose, impaired glucose tolerance and diabetes) was determined using the Kaplan-Meier method of survival analysis. Cox regression models were constructed to test for factors predicting abnormal glucose tolerance. Results: Twenty-six percent of women with previous GDM had abnormal glucose tolerance vs 4% with NGT, with the log-rank test demonstrating significantly different survival curves (P < 0.001). Women meeting IADPSG, but not the World Health Organization (WHO) 1999 criteria, had a lower cumulative incidence than women meeting both sets of criteria, both in the early post-partum period (4.2% vs 21.7%, P < 0.001) and at longer-term follow-up (13.7% vs 32.6%, P < 0.001). Predictive factors were glucose levels on the pregnancy oral glucose tolerance test, family history of diabetes, gestational week at testing, and BMI at follow-up. Conclusions: The proportion of women developing abnormal glucose tolerance remains high among those with IADPSG-defined GDM. This demonstrates the need for continued close follow-up, although the optimal frequency and method needs further study.

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Section: Discussionsupporting

confidence: 83%

Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria

Noctor

Crowe

Carmody

et al. 2016

European Journal of Endocrinology

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“…Our previous work supported that BMI was associated with an increased risk of type 2 diabetes among women with prior GDM. [33] In the present study, we also found a significant correlation between UA levels and BMI (r 2 = 0.149, P<0.001). Many studies found that the associations between UA levels and the risk of type 2 diabetes or prediabetes somewhat attenuated or vanished when BMI was entered into the models [4,26,28,34].…”

Section: Discussionsupporting

confidence: 80%

Uric acid and diabetes risk among Chinese women with a history of gestational diabetes mellitus

Leng

Wang

et al. 2017

Diabetes Research and Clinical Practice

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Aims To assess the association of uric acid (UA) with the risks of postpartum type 2 diabetes and prediabetes among women with prior gestational diabetes mellitus (GDM). Methods We performed a cross-sectional study of 1262 GDM women at 1–5 years after delivery using the baseline data from the Tianjin Gestational Diabetes Mellitus Prevention Program. Logistic regression models were used to estimate the association of different levels of serum UA with the risks of type 2 diabetes and prediabetes. Results The multivariable-adjusted odds ratios (ORs) across quartiles of serum UA were 1.00, 1.23 (95% confidence interval [CI] 0.55–2.78), 2.05 (95% CI 0.96–4.39), and 3.17 (95% CI 1.54–6.55) (Ptrend<0.001) for type 2 diabetes, and 1.00, 1.50 (95% CI 1.03–2.19), 2.28 (95% CI 1.58–3.30), and 2.88 (95% CI 1.99–4.17) (Ptrend<0.001) for prediabetes, respectively. Restricted cubic splines models showed positive linear associations of serum UA as a continuous variable with the risks of type 2 diabetes and prediabetes. This positive association was significant when stratified by healthy weight and overweight participants. Conclusions Serum UA levels have a graded positive association with the risks of type 2 diabetes and prediabetes among Chinese with a history of GDM.

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“…A total of 4,644 pregnant women who were diagnosed with GDM from 2005 to 2009 and their children in six urban districts were invited to participate in a baseline survey for the TGDMPP. Finally, 1263 GDM women and their children had completed the baseline survey for the TGDMPP from August 2009 to July 2011 (participation rate 27%)193940414243. The study followed the guidelines of the Helsinki Declaration, and was approved by the Human Subjects Committee of the Tianjin Women’s and Children’s Health Center, informed consent was obtained for each participant.…”

Section: Methodsmentioning

confidence: 99%

Physical Activity, TV Watching Time, Sleeping, and Risk of Obesity and Hyperglycemia in the Offspring of Mothers with Gestational Diabetes Mellitus

Zhang

Wang

Liu

et al. 2017

Sci Rep

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We investigated the association of physical activity, TV watching time, sleeping time with the risks of obesity and hyperglycemia among 1263 offspring aged 1–5 years of mothers with gestational diabetes (GDM) in a cross-sectional study. Logistic regression models were used to obtain the odd ratios (ORs) (95% confidence intervals [CI]) of childhood obesity and hyperglycemia associated with different levels of indoor activity, outdoor activity, TV watching, and sleeping time. The multivariable-adjusted ORs of obesity based on different levels of TV watching time (0, <1.0, and ≥1.0 hour/day) were 1.00, 1.21 (95% CI 0.72–2.05), and 2.20 (95% CI 1.33–3.63) (Ptrend = 0.003), respectively. The multivariable-adjusted ORs of hyperglycemia based on different levels of indoor activity (<5.0, 5.0–6.9, and ≥7.0 hours/day) were 1.00, 0.74 (95% CI 0.45–1.21), and 0.49 (95% CI 0.28–0.84) (Ptrend = 0.034), respectively. The multivariable-adjusted ORs of hyperglycemia associated with different levels of sleeping time (<11.0, 11.0–11.9, and ≥12.0 hours/day) were 1.00, 0.67 (95% CI 0.42–1.05), and 0.39 (95% CI 0.23–0.67) (Ptrend = 0.003), respectively. The present study indicated a positive association of TV watching with the risk of obesity, and an inverse association of either indoor activity or sleeping time with the risk of hyperglycemia among offspring born to GDM mothers in Tianjin, China.

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Obesity index and the risk of diabetes among Chinese women with prior gestational diabetes

Abstract: BMI, waist circumference and body fat were all associated with an increased risk of Type 2 diabetes, and waist circumference and body fat were better indicators than BMI for Type 2 diabetes risk among Chinese women with prior gestational diabetes.

Cited by 31 publications

References 28 publications

Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria

Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria

Uric acid and diabetes risk among Chinese women with a history of gestational diabetes mellitus

Physical Activity, TV Watching Time, Sleeping, and Risk of Obesity and Hyperglycemia in the Offspring of Mothers with Gestational Diabetes Mellitus

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