《糖尿病学》：妊娠性糖尿病的肥胖孕妇产后增重5kg，患二型糖尿病的风险增加40多倍

Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study 2型糖尿病的长期风险与BMI指数以及有妊娠糖尿病史的妇女其体重变化的关系：一次前瞻性队列研究 Abstract 摘要 Aims/hypothesis Womenwith a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM. 目标/假设 建议有妊娠糖尿病史（GDM）的妇女产后要控制体重。本次研究的目的是检验肥胖症及体重变化如何影响有妊娠糖尿病史的妇女患2型糖尿病的长期风险。 Methods We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women’s Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially.We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models. 方法 选择1991年至2001年间患有妊娠糖尿病的1,695名妇女作为“肥胖与妇女健康研究”的一部分研究对象，对她们进行跟踪调查，调查问卷进行到2009年。每2年报告一次体重及2型糖尿病的发病率。我们把报告妊娠糖尿病病例的问卷调查时间作为基准。使用Cox比例风险模型预测风险比及95%可信区间。 Results We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjustedHRs of type 2 diabetes associated with each 1 kg/m2 increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI and 1.16 (95% CI 1.13, 1.20) for most recent BMI. Moreover, each 5 kg increment of weight gain after GDM development was associated with a 27% higher risk of type 2 diabetes (adjusted HR 1.27; 95%CI 1.04, 1.54). Jointly, women who had a BMI ≥30.0 kg/m2 at baseline and gained ≥5 kg after GDM had an adjusted HR of 43.19 (95% CI 13.60, 137.11), compared with women who had a BMI <25.0 kg/m2 at baseline and gained <5 kg after GDM. 结果 我们记录了259例18岁及以上的患有2型糖尿病的病例。参照基准BMI，BMI每增加1 kg/m2，2型糖尿病的校正风险比为1.16 (95% CI 1.12, 1.19)；参照最近的BMI,BMI每增加1 kg/m2，2型糖尿病的校正风险比为1.16 (95% CI 1.13, 1.20)。同时，对于妊娠糖尿病患者，体重每增长5Kg，2型糖尿病的患病风险就增加27%，(校正HR 为1.27; 95%CI 1.04, 1.54)。与基准水平上BMI<25.0Kg/m2,并且体重增加不超过5Kg的患妊娠糖尿病的妇女相比，在基准水平上BMI≥30.0 Kg/m2并且体重增加大于等于5Kg的患妊娠糖尿病的妇女的校正HR为43.19 (95% CI 13.60, 137.11)。 Conclusions/interpretation Baseline BMI, most recent BMI and weight gain after GDM were significantly and positively associated with risk of progression from GDM to type 2 diabetes. 总结/解释 基准BMI，最近BMI以及产后妊娠糖尿病患者的体重变化与妊娠糖尿病向2型糖尿病转化的风险有显著的正相关。 Keywords BMI . Gestational diabetesmellitus . Type 2 diabetes mellitus .Weight change 关键词 BMI 妊娠糖尿病 2型糖尿病 体重变化

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非常感谢，我有空校对一下