Association of gestational diabetes with long-term risk of premature mortality, and cardiovascular outcomes and risk factors: A retrospective cohort analysis in the UK Biobank
Metadatos
Mostrar el registro completo del ítemAutor
Michalopoulou, Moscho; Piernas Sánchez, Carmen María; Jebb, Susan A.; Gao, Min; Astbury, Nerys M.Editorial
Wiley Online Library
Materia
cardiovascular disease cohort study diabetes complications
Fecha
2024-04-28Referencia bibliográfica
Michalopoulou, M. Diabetes Obes Metab. 2024;26(7):2915‐2924. [https://doi.org/10.1111/dom.15612]
Patrocinador
National Institute for Health and Care Research Applied Research Collaboration Oxford and Thames Valley; British Nutrition Foundation; NIHR Oxford Health Biomedical Research Centre; NIHR Oxford Biomedical Research Centre; Ministerio de Ciencia e Innovación. Grant Numbers: RYC2020-028818-I, MCIN/AEI/10.13039/501100011033Resumen
Aim: To investigate the association of gestational diabetes mellitus (GDM) with premature
mortality and cardiovascular (CVD) outcomes and risk factors.
Materials and Methods: Parous women recruited to the UK Biobank cohort during
2006-2010 were followed up from their first delivery until 31 October 2021. The
data were linked to Hospital Episode Statistics and mortality registries. Multivariate
Cox proportional hazard models investigated associations of GDM with all-cause
mortality, CVD, diabetes, hypertension and dyslipidaemia.
Results: The maximum total analysis time at risk and under observation was
9 694 090 person-years. Among 220 726 women, 1225 self-reported or had a
recorded diagnosis of GDM. After adjusting for confounders and behavioural
factors, GDM was associated with increased risk for premature mortality [hazard
ratio (HR): 1.44, 95% confidence interval (CI): 1.12-1.86], particularly CVD-related
death (HR: 2.38, 95% CI: 1.63-3.48), as well as incident total CVD (HR: 1.50,
95% CI: 1.30-1.74), non-fatal CVD (HR: 1.41, 95% CI: 1.20-1.65), diabetes (HR:
14.37, 95% CI: 13.51-15.27), hypertension (HR: 1.49, 95% CI: 1.38-1.60), and dyslipidaemia
(HR: 1.30, 95% CI: 1.22-1.39). The total CVD risk was greater in
women with GDM who did not later develop diabetes than in those with GDM
and diabetes.
Conclusions: Women with GDM are at increased risk of premature death and have
increased CV risk, emphasizing the importance of interventions to prevent GDM.
If GDM develops, the diagnosis represents an opportunity for future surveillance
and intervention to reduce CVD risk factors, prevent CVD and improve long-term
health.