Metabolic syndrome in women with previous gestational diabetes

Abstract To evaluate the incidence and timing of the diagnosis of metabolic syndrome in a cohort of Danish women after a pregnancy with gestational diabetes (GDM) to estimate the optimum time for preventative actions in relation to metabolic syndrome (MetS). In this follow-up study, 435 women were i...

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Autores principales:	Karsten Kaiser, Michael Festersen Nielsen, Ervin Kallfa, Greta Dubietyte, Finn Friis Lauszus
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5abbedfbf4bb42efaa1b5cd88c06a7c4
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spelling	oai:doaj.org-article:5abbedfbf4bb42efaa1b5cd88c06a7c42021-12-02T15:02:49ZMetabolic syndrome in women with previous gestational diabetes10.1038/s41598-021-90832-02045-2322https://doaj.org/article/5abbedfbf4bb42efaa1b5cd88c06a7c42021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-90832-0https://doaj.org/toc/2045-2322Abstract To evaluate the incidence and timing of the diagnosis of metabolic syndrome in a cohort of Danish women after a pregnancy with gestational diabetes (GDM) to estimate the optimum time for preventative actions in relation to metabolic syndrome (MetS). In this follow-up study, 435 women were included from a consecutive cohort with prior history of GDM. Data on dyslipidemia, hypertension and other cardiovascular disorders (CVD) were extracted from the electronic patient journal. Any antidiabetic, cardiovascular and cholesterol-lowering medicine was ascertained in the national prescription database. Similarly, any blood test taken was evaluated. We defined a patient having MetS if the criteria of the WHO based definition of diabetes or impaired glucose regulation were met. Further, we added as alternative for glucose intolerance, a glycosylated hemoglobin (HbA1c) > 44 mmol/mol or the former level ≥ 6.5%. Further, dyslipidemia, lipid lowering medications, BMI > 30 kg/m2 or antihypertensive treatment were used. For MetS outcome, diagnosis or medication for CVD was registered. All women were followed for median 5.7 years (range 0; 9). The incidence of MetS was 28%. Thirteen percent of these qualified already within one year after pregnancy for the diagnosis of MetS. Postpartum MetS was detected after a median of 3 years (range 0; 7 years); further, 36 (8%) had been diagnosed with manifest diabetes after pregnancy. The diagnosis of postpartum MetS was strongly associated with the prevalence of manifest diabetes. Six years after pregnancy the rate of metabolic syndrome was more than tripled (25 vs. 89%, no DM vs manifest DM, RR: 6.7; 95% CI 2.7–17, p < 0.001). At 40 years the MetS rate nearly tripled if manifest DM was diagnosed (26 vs. 78%, no DM vs. manifest DM, RR: 3.3, 95% CI 1.8–6, p < 0.001). We found that GDM and later on manifest DM in women increase the risk of metabolic syndrome. There seems to be a window of opportunity before the early thirties where it would be especially beneficial to begin preventive efforts in women with GDM.Karsten KaiserMichael Festersen NielsenErvin KallfaGreta DubietyteFinn Friis LauszusNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Karsten Kaiser Michael Festersen Nielsen Ervin Kallfa Greta Dubietyte Finn Friis Lauszus Metabolic syndrome in women with previous gestational diabetes
description	Abstract To evaluate the incidence and timing of the diagnosis of metabolic syndrome in a cohort of Danish women after a pregnancy with gestational diabetes (GDM) to estimate the optimum time for preventative actions in relation to metabolic syndrome (MetS). In this follow-up study, 435 women were included from a consecutive cohort with prior history of GDM. Data on dyslipidemia, hypertension and other cardiovascular disorders (CVD) were extracted from the electronic patient journal. Any antidiabetic, cardiovascular and cholesterol-lowering medicine was ascertained in the national prescription database. Similarly, any blood test taken was evaluated. We defined a patient having MetS if the criteria of the WHO based definition of diabetes or impaired glucose regulation were met. Further, we added as alternative for glucose intolerance, a glycosylated hemoglobin (HbA1c) > 44 mmol/mol or the former level ≥ 6.5%. Further, dyslipidemia, lipid lowering medications, BMI > 30 kg/m2 or antihypertensive treatment were used. For MetS outcome, diagnosis or medication for CVD was registered. All women were followed for median 5.7 years (range 0; 9). The incidence of MetS was 28%. Thirteen percent of these qualified already within one year after pregnancy for the diagnosis of MetS. Postpartum MetS was detected after a median of 3 years (range 0; 7 years); further, 36 (8%) had been diagnosed with manifest diabetes after pregnancy. The diagnosis of postpartum MetS was strongly associated with the prevalence of manifest diabetes. Six years after pregnancy the rate of metabolic syndrome was more than tripled (25 vs. 89%, no DM vs manifest DM, RR: 6.7; 95% CI 2.7–17, p < 0.001). At 40 years the MetS rate nearly tripled if manifest DM was diagnosed (26 vs. 78%, no DM vs. manifest DM, RR: 3.3, 95% CI 1.8–6, p < 0.001). We found that GDM and later on manifest DM in women increase the risk of metabolic syndrome. There seems to be a window of opportunity before the early thirties where it would be especially beneficial to begin preventive efforts in women with GDM.
format	article
author	Karsten Kaiser Michael Festersen Nielsen Ervin Kallfa Greta Dubietyte Finn Friis Lauszus
author_facet	Karsten Kaiser Michael Festersen Nielsen Ervin Kallfa Greta Dubietyte Finn Friis Lauszus
author_sort	Karsten Kaiser
title	Metabolic syndrome in women with previous gestational diabetes
title_short	Metabolic syndrome in women with previous gestational diabetes
title_full	Metabolic syndrome in women with previous gestational diabetes
title_fullStr	Metabolic syndrome in women with previous gestational diabetes
title_full_unstemmed	Metabolic syndrome in women with previous gestational diabetes
title_sort	metabolic syndrome in women with previous gestational diabetes
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/5abbedfbf4bb42efaa1b5cd88c06a7c4
work_keys_str_mv	AT karstenkaiser metabolicsyndromeinwomenwithpreviousgestationaldiabetes AT michaelfestersennielsen metabolicsyndromeinwomenwithpreviousgestationaldiabetes AT ervinkallfa metabolicsyndromeinwomenwithpreviousgestationaldiabetes AT gretadubietyte metabolicsyndromeinwomenwithpreviousgestationaldiabetes AT finnfriislauszus metabolicsyndromeinwomenwithpreviousgestationaldiabetes
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Metabolic syndrome in women with previous gestational diabetes

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