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History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women

BACKGROUND: Findings from previous studies examining the association between gestational diabetes mellitus (GDM) and subsequent risk of cardiovascular disease (CVD) have been inconsistent and inconclusive. We aimed to examine the associations of a previous history of GDM with risk of CVD and status...

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Autores principales: Shostrom, Derrick C. V., Sun, Yangbo, Oleson, Jacob J., Snetselaar, Linda G., Bao, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483836/
https://www.ncbi.nlm.nih.gov/pubmed/28694789
http://dx.doi.org/10.3389/fendo.2017.00144
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author Shostrom, Derrick C. V.
Sun, Yangbo
Oleson, Jacob J.
Snetselaar, Linda G.
Bao, Wei
author_facet Shostrom, Derrick C. V.
Sun, Yangbo
Oleson, Jacob J.
Snetselaar, Linda G.
Bao, Wei
author_sort Shostrom, Derrick C. V.
collection PubMed
description BACKGROUND: Findings from previous studies examining the association between gestational diabetes mellitus (GDM) and subsequent risk of cardiovascular disease (CVD) have been inconsistent and inconclusive. We aimed to examine the associations of a previous history of GDM with risk of CVD and status of cardiovascular risk factors in a nationwide population-based study in the United States. METHODS: This study included 8,127 parous women aged 20 years or older in the 2007–2014 cycles of the National Health and Nutrition Examination Survey in the United States. The exposure was self-reported diagnostic history of GDM and the outcomes were self-reported diagnostic history of CVD and measurements of cardiovascular risk factors, including blood pressure and blood lipids. Regression models with sample weights were used to examine the associations of GDM with CVD and cardiovascular risk factors. RESULTS: Among women with a history of both GDM and CVD, CVD was diagnosed on average 22.9 years after the diagnosis of GDM. After adjustment for demographic, socioeconomic, and lifestyle factors, a history of GDM was associated with 63% higher odds of CVD [odds ratio (OR) 1.63, 95% confidence interval (CI) 1.02, 2.62, p-value = 0.04]. Further adjustment for body mass index (BMI) modestly attenuated the association (OR 1.52, 95% CI 0.95, 2.44, p-value = 0.08). A history of GDM was significantly associated with lower serum level of HDL-cholesterol (adjusted β-coefficient −3.33, 95% CI −5.17, −1.50, p-value ≤ 0.001), but not associated with total cholesterol, LDL-cholesterol, triglycerides, or systolic or diastolic blood pressure. Similarly, the association between a history of GDM and HDL cholesterol was attenuated after additional adjustment for BMI (adjusted β-coefficient −1.68, 95% CI −3.38, 0.03, p-value = 0.54). CONCLUSION: Women with a previous history of GDM have significantly higher risk for developing CVD and lower serum level of HDL cholesterol, compared to women without a history of GDM. The associations may be explained, at least partly, by BMI.
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spelling pubmed-54838362017-07-10 History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women Shostrom, Derrick C. V. Sun, Yangbo Oleson, Jacob J. Snetselaar, Linda G. Bao, Wei Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Findings from previous studies examining the association between gestational diabetes mellitus (GDM) and subsequent risk of cardiovascular disease (CVD) have been inconsistent and inconclusive. We aimed to examine the associations of a previous history of GDM with risk of CVD and status of cardiovascular risk factors in a nationwide population-based study in the United States. METHODS: This study included 8,127 parous women aged 20 years or older in the 2007–2014 cycles of the National Health and Nutrition Examination Survey in the United States. The exposure was self-reported diagnostic history of GDM and the outcomes were self-reported diagnostic history of CVD and measurements of cardiovascular risk factors, including blood pressure and blood lipids. Regression models with sample weights were used to examine the associations of GDM with CVD and cardiovascular risk factors. RESULTS: Among women with a history of both GDM and CVD, CVD was diagnosed on average 22.9 years after the diagnosis of GDM. After adjustment for demographic, socioeconomic, and lifestyle factors, a history of GDM was associated with 63% higher odds of CVD [odds ratio (OR) 1.63, 95% confidence interval (CI) 1.02, 2.62, p-value = 0.04]. Further adjustment for body mass index (BMI) modestly attenuated the association (OR 1.52, 95% CI 0.95, 2.44, p-value = 0.08). A history of GDM was significantly associated with lower serum level of HDL-cholesterol (adjusted β-coefficient −3.33, 95% CI −5.17, −1.50, p-value ≤ 0.001), but not associated with total cholesterol, LDL-cholesterol, triglycerides, or systolic or diastolic blood pressure. Similarly, the association between a history of GDM and HDL cholesterol was attenuated after additional adjustment for BMI (adjusted β-coefficient −1.68, 95% CI −3.38, 0.03, p-value = 0.54). CONCLUSION: Women with a previous history of GDM have significantly higher risk for developing CVD and lower serum level of HDL cholesterol, compared to women without a history of GDM. The associations may be explained, at least partly, by BMI. Frontiers Media S.A. 2017-06-26 /pmc/articles/PMC5483836/ /pubmed/28694789 http://dx.doi.org/10.3389/fendo.2017.00144 Text en Copyright © 2017 Shostrom, Sun, Oleson, Snetselaar and Bao. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Shostrom, Derrick C. V.
Sun, Yangbo
Oleson, Jacob J.
Snetselaar, Linda G.
Bao, Wei
History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women
title History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women
title_full History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women
title_fullStr History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women
title_full_unstemmed History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women
title_short History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women
title_sort history of gestational diabetes mellitus in relation to cardiovascular disease and cardiovascular risk factors in us women
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483836/
https://www.ncbi.nlm.nih.gov/pubmed/28694789
http://dx.doi.org/10.3389/fendo.2017.00144
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