产前口服葡萄糖耐量试验异常在预测妊娠糖尿病妇女未来产后糖尿病风险中的作用:LIVING 研究的结果

IF 3 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM Journal of Diabetes Pub Date : 2024-05-06 DOI:10.1111/1753-0407.13559
Yashdeep Gupta, Deksha Kapoor, Josyula K. Lakshmi, Devarsetty Praveen, Joseph Alvin Santos, Laurent Billot, Aliya Naheed, H. Asita de Silva, Ishita Gupta, Noshin Farzana, Renu John, Saumiyah Ajanthan, Neerja Bhatla, Ankush Desai, Arunasalam Pathmeswaran, Dorairaj Prabhakaran, Helena Teede, Sophia Zoungas, Anushka Patel, Nikhil Tandon
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引用次数: 0

摘要

目的 探讨根据国际糖尿病和妊娠研究小组协会标准诊断为妊娠糖尿病(GDM)的南亚妇女产前口服葡萄糖耐量试验(OGTT)血糖异常值的类型和数量与产后糖尿病之间的关系。 方法 孟加拉国、印度和斯里兰卡的 19 个中心对妊娠期糖尿病生活方式干预(LIVING)研究(一项随机对照试验)进行了事后评估。根据美国糖尿病协会(ADA)的标准,产后糖尿病(结果)根据 OGTT 进行定义。 结果 我们报告了 1468 名 GDM 妇女的数据,这些妇女的年龄为 30.9 (5.0)岁,产后随访时间的中位数(四分位数间距)为 1.8 (1.4-2.4)年。我们在 213 名(14.5%)妇女中发现了糖尿病,发病率为 8.7(7.6-10.0)/100 名妇女-年。在仅有一次空腹血浆葡萄糖(FPG)异常的妇女中,发病率最低,为 3.8/100妇女年;在有三次异常值的妇女中,发病率最高,为 19.0/100妇女年。与一个异常值相比,两个和三个异常值的调整后危险比分别为 1.73(95% 置信区间 [CI],1.18-2.54;p = .005)和 3.56(95% 置信区间,2.46-5.16;p <.001)。与单独的 FPG 异常相比,合并(空腹和糖负荷后的合并)异常的调整后危险比为 2.61 (95% CI, 1.70-4.00; p <.001)。 结论 患糖尿病的风险因产前 OGTT 异常值的类型和数量不同而有显著差异。这些数据可为未来的精准医疗方法(如风险预测模型)提供参考,以识别高风险产妇,并为未来的针对性干预措施提供指导。
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Antenatal oral glucose tolerance test abnormalities in the prediction of future risk of postpartum diabetes in women with gestational diabetes: Results from the LIVING study

Objectives

To explore associations between type and number of abnormal glucose values on antenatal oral glucose tolerance test (OGTT) with postpartum diabetes in South Asian women diagnosed with gestational diabetes (GDM) using International Association of the Diabetes and Pregnancy Study Groups criteria.

Methods

This post-hoc evaluation of the Lifestyle Intervention IN Gestational Diabetes (LIVING) study, a randomized controlled trial, was conducted among women with GDM in the index pregnancy, across 19 centers in Bangladesh, India, and Sri Lanka. Postpartum diabetes (outcome) was defined on OGTT, using American Diabetes Association (ADA) criteria.

Results

We report data on 1468 women with GDM, aged 30.9 (5.0) years, and with median (interquartile range) follow-up period of 1.8 (1.4–2.4) years after childbirth following the index pregnancy. We found diabetes in 213 (14.5%) women with an incidence of 8.7 (7.6–10.0)/100 women-years. The lowest incidence rate was 3.8/100 women years, in those with an isolated fasting plasma glucose (FPG) abnormality, and highest was 19.0/100 women years in participants with three abnormal values. The adjusted hazard ratios for two and three abnormal values compared to one abnormal value were 1.73 (95% confidence interval [CI], 1.18–2.54; p = .005) and 3.56 (95% CI, 2.46–5.16; p < .001) respectively. The adjusted hazard ratio for the combined (combination of fasting and postglucose load) abnormalities was 2.61 (95% CI, 1.70–4.00; p < .001), compared to isolated abnormal FPG.

Conclusions

Risk of diabetes varied significantly depending upon the type and number of abnormal values on antenatal OGTT. These data may inform future precision medicine approaches such as risk prediction models in identifying women at higher risk and may guide future targeted interventions.

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来源期刊
Journal of Diabetes
Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
CiteScore
6.50
自引率
2.20%
发文量
94
审稿时长
>12 weeks
期刊介绍: Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.
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