Fasting glucose concentrations and associations with reproductive history over 40 years of follow-up

Abstract

Gestational diabetes mellitus (GDM) is the onset or first recognition of diabetes that occurs during pregnancy. We aimed to assess for trends in fasting blood glucose levels across the life-course among a cohort of women by reproductive history: nulligravid women, gravid women with and without a history of GDM. Women who had participated in the Bogalusa Heart Study as children were interviewed about their reproductive history, including GDM (n = 358). We compared fasting blood glucose (mg/dL) measured after last pregnancy (or after age 40 among nulligravid women) across reproductive history groups in linear models adjusted for prepregnancy fasting blood glucose, body mass index, race, parity, and age at outcome measure. We fit a log-Poisson model to estimate the associations with prediabetes risk after age 40. After adjustments, mean fasting glucose after age 40 was not different between gravid women without GDM history and nulligravid women. However, women with a history of GDM had mean fasting glucose 27 mg/dL greater than nulligravid women (95% CI = 12.35, 41.64). Heterogeneity by race indicated Black women with a history of GDM had disproportionately elevated mean fasting glucose after age 40. Fasting blood glucose trends over the life-course differ among women by reproductive history and race.

Chinese abstract

空腹血糖浓度与生育史的相关性40余年的随访

摘要

妊娠期糖尿病(GDM)是指在妊娠期发生或首次被确诊的糖尿病。我们的目的是评估女性一生中空腹血糖水平的趋势, 通过她们的生育史将她们分为:未孕女性、无GDM病史有妊娠史女性和有GDM病史的女性。参与了Bogalusa心脏研究的母子均被采访了关于他们的生育历史,包括GDM(n= 358)。我们将妊娠后(或未孕女性40岁以后)的空腹血糖(mg/dL)进行了线性模型的比较, 这些模型是根据妊娠前空腹血糖、体重指数、种族、生育能力和年龄进行调整的。我们采用log-Poisson模型来估计40岁后患糖尿病前期的风险。经过调整后, 40岁后的空腹血糖在无GDM病史的妊娠妇女和未孕妇女之间无差异。然而, 有GDM病史女性的平均空腹血糖27 mg/dL大于未孕女性(95%可信区间=12.35,41.64)。种族的异质性表明, 有GDM历史的黑人女性在40岁以后的平均空腹血糖最高。女性一生中空腹血糖趋势因生育史和种族而异。

关键词: 妊娠；胰岛素依赖；糖尿病

Keywords:

• Pregnancy
• insulin resistance
• diabetes

Disclosure statement

The authors report no conflict of interest.

Additional information

Funding

The Bogalusa Heart Study is supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD069587, R01HD032194), the National Institute on Aging (R01AG041200), and the National Heart, Lung, and Blood Institute P50HL015103, R01HL016592).