Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

doi:10.1016/j.diabres.2019.107828

. 2019 Oct:156:107828.

doi: 10.1016/j.diabres.2019.107828. Epub 2019 Aug 28.

Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

Yuxin Fan¹, Weiqin Li², Huikun Liu², Leishen Wang², Shuang Zhang², Wei Li², Hongyan Liu², Junhong Leng², Yun Shen³, Jaakko Tuomilehto⁴, Zhijie Yu⁵, Xilin Yang⁶, Ming Liu⁷, Gang Hu⁸

Affiliations

¹ Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China; Pennington Biomedical Research Center, Baton Rouge, LA, USA.
² Tianjin Women's and Children's Health Center, Tianjin, China.
³ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Six People's Hospital, Shanghai, China.
⁴ Department of Public Health, University of Helsinki, Helsinki, Finland.
⁵ Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada.
⁶ Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China.
⁷ Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
⁸ Pennington Biomedical Research Center, Baton Rouge, LA, USA. Electronic address: gang.hu@pbrc.edu.

PMID: 31472162
PMCID: PMC6858564
DOI: 10.1016/j.diabres.2019.107828

Free PMC article

Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

Yuxin Fan et al. Diabetes Res Clin Pract. 2019 Oct.

Free PMC article

. 2019 Oct:156:107828.

doi: 10.1016/j.diabres.2019.107828. Epub 2019 Aug 28.

Authors

Yuxin Fan¹, Weiqin Li², Huikun Liu², Leishen Wang², Shuang Zhang², Wei Li², Hongyan Liu², Junhong Leng², Yun Shen³, Jaakko Tuomilehto⁴, Zhijie Yu⁵, Xilin Yang⁶, Ming Liu⁷, Gang Hu⁸

Affiliations

¹ Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China; Pennington Biomedical Research Center, Baton Rouge, LA, USA.
² Tianjin Women's and Children's Health Center, Tianjin, China.
³ Pennington Biomedical Research Center, Baton Rouge, LA, USA; Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Six People's Hospital, Shanghai, China.
⁴ Department of Public Health, University of Helsinki, Helsinki, Finland.
⁵ Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada.
⁶ Department of Epidemiology, School of Public Health, Tianjin Medical University, Tianjin, China.
⁷ Department of Endocrinology and Metabolism, Tianjin Medical University General Hospital, Tianjin, China.
⁸ Pennington Biomedical Research Center, Baton Rouge, LA, USA. Electronic address: gang.hu@pbrc.edu.

PMID: 31472162
PMCID: PMC6858564
DOI: 10.1016/j.diabres.2019.107828

Abstract

Objective: To evaluate the independent or combined effects of gestational diabetes (GDM) and pre-pregnancy and postpartum BMI on the odds of postpartum diabetes and hyperglycemia.

Methods: The study samples included 1263 women with prior GDM and 705 women without GDM. Postpartum 1-7 years diabetes was diagnosed by the standard oral glucose tolerance test.

Results: The multivariable-adjusted odds ratios among women with prior GDM, compared with those without it, were 7.52 for diabetes and 2.27 for hyperglycemia. The multivariable-adjusted odds ratios at different postpartum BMI levels (<24, 24-27.9, and ≥ 28 kg/m²) were 1.00, 2.80, and 8.08 for diabetes (P_trend < 0.001), and 1.00, 2.10, and 4.42 for hyperglycemia (P_trend < 0.001), respectively. Women with high body fat (≥31.9%) or abdominal obesity (≥85 cm) had a 2.7-6.9-fold higher odds ratio for diabetes or hyperglycemia. Women with both obesity and prior GDM had the highest risk of diabetes or hyperglycemia compared with non-obese women without GDM. Non-obese women with prior GDM had the same risk of diabetes and hyperglycemia as non-GDM women with obesity. When using Cox regression models, the results were very close to those using logistic regression models.

Conclusions: Maternal prior GDM and pre-pregnancy or postpartum obesity contribute equally to postpartum diabetes and hyperglycemia risk.

Keywords: BMI; Diabetes risks; Gestational diabetes.

PubMed Disclaimer

Conflict of interest statement

Disclosure: The authors have no competing interests in this article.

Duality of interest

The authors have no competing interests in this article.

Figures

**Figure 1.**
The cumulative incidence curve of type 2 diabetes (A) and hyperglycemia (B) according to combined effects of maternal GDM and obesity status. Adjusted for age, education, family income, family history of diabetes, current smoking, passive smoking, current alcohol drinking, leisure-time physical activity, sleeping time, dietary fiber, sweetened beverage drinking, energy intakes of fat, protein, and carbohydrate. GDM, gestational diabetes mellitus.

See this image and copyright information in PMC

Cited by

Weight Categories, Trajectories, Eating Behavior, and Metabolic Consequences during Pregnancy and Postpartum in Women with GDM.
Schenk S, Ravussin Y, Lacroix A, Quansah DY, Puder JJ. Schenk S, et al. Nutrients. 2024 Feb 18;16(4):560. doi: 10.3390/nu16040560. Nutrients. 2024. PMID: 38398884 Free PMC article.
The Role of Phytochemicals and Plant-Based Diets in Gestational Diabetes: Evidence from Clinical Trials.
Jaworsky K, DeVillez P, Basu A. Jaworsky K, et al. Int J Environ Res Public Health. 2023 Feb 26;20(5):4188. doi: 10.3390/ijerph20054188. Int J Environ Res Public Health. 2023. PMID: 36901197 Free PMC article. Review.
EHBP1, TUBB, and WWOX SNPs, Gene-Gene and Gene-Environment Interactions on Coronary Artery Disease and Ischemic Stroke.
Liu CX, Yin RX, Cao XL, Shi ZH, Huang F, Wei BL, Deng GX, Zheng PF, Guan YZ. Liu CX, et al. Front Genet. 2022 Apr 26;13:843661. doi: 10.3389/fgene.2022.843661. eCollection 2022. Front Genet. 2022. PMID: 35559044 Free PMC article.
Annual Body Mass Index Gain and Risk of Gestational Diabetes Mellitus in a Subsequent Pregnancy.
Tano S, Kotani T, Ushida T, Yoshihara M, Imai K, Nakano-Kobayashi T, Moriyama Y, Iitani Y, Kinoshita F, Yoshida S, Yamashita M, Kishigami Y, Oguchi H, Kajiyama H. Tano S, et al. Front Endocrinol (Lausanne). 2022 Mar 25;13:815390. doi: 10.3389/fendo.2022.815390. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35399932 Free PMC article.
miRNAs as Predictive Factors in Early Diagnosis of Gestational Diabetes Mellitus.
Juchnicka I, Kuźmicki M, Niemira M, Bielska A, Sidorkiewicz I, Zbucka-Krętowska M, Krętowski AJ, Szamatowicz J. Juchnicka I, et al. Front Endocrinol (Lausanne). 2022 Mar 7;13:839344. doi: 10.3389/fendo.2022.839344. eCollection 2022. Front Endocrinol (Lausanne). 2022. PMID: 35340328 Free PMC article.

See all "Cited by" articles

References

1. Consulatation WHO. Definition, diagnosis and classification of diabetes mellitus and its complications Part 1: diagnosis and classification of diabetes mellitus. Geneva, World Health Organization, 1999.
1. Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al. Prevalence of Gestational Diabetes Mellitus and Its Risk Factors in Chinese Pregnant Women: A Prospective Population-Based Study in Tianjin, China. PLoS One. 2015;10:e0121029. - PMC - PubMed
1. Zhang F, Dong L, Zhang CP, Li B, Wen J, Gao W, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008. Diabet Med. 2011;28:652–7. - PubMed
1. Gestational diabetes mellitus. Diabetes care. 2003;26 Suppl 1:S103–5. - PubMed
1. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–9. - PubMed

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Medical
- Genetic Alliance
- MedlinePlus Health Information

[1] Consulatation WHO. Definition, diagnosis and classification of diabetes mellitus and its complications Part 1: diagnosis and classification of diabetes mellitus. Geneva, World Health Organization, 1999.

[2] Consulatation WHO. Definition, diagnosis and classification of diabetes mellitus and its complications Part 1: diagnosis and classification of diabetes mellitus. Geneva, World Health Organization, 1999.

[3] Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al. Prevalence of Gestational Diabetes Mellitus and Its Risk Factors in Chinese Pregnant Women: A Prospective Population-Based Study in Tianjin, China. PLoS One. 2015;10:e0121029. - PMC - PubMed

[4] Leng J, Shao P, Zhang C, Tian H, Zhang F, Zhang S, et al. Prevalence of Gestational Diabetes Mellitus and Its Risk Factors in Chinese Pregnant Women: A Prospective Population-Based Study in Tianjin, China. PLoS One. 2015;10:e0121029. - PMC - PubMed

[5] Zhang F, Dong L, Zhang CP, Li B, Wen J, Gao W, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008. Diabet Med. 2011;28:652–7. - PubMed

[6] Zhang F, Dong L, Zhang CP, Li B, Wen J, Gao W, et al. Increasing prevalence of gestational diabetes mellitus in Chinese women from 1999 to 2008. Diabet Med. 2011;28:652–7. - PubMed

[7] Gestational diabetes mellitus. Diabetes care. 2003;26 Suppl 1:S103–5. - PubMed

[8] Gestational diabetes mellitus. Diabetes care. 2003;26 Suppl 1:S103–5. - PubMed

[9] Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–9. - PubMed

[10] Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet. 2009;373:1773–9. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

Affiliations

Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Abstract

Conflict of interest statement

Figures

Similar articles

Cited by

References

MeSH terms

Related information

Grants and funding

LinkOut - more resources

Full Text Sources

Medical