Abstract
Women with previous gestational diabetes mellitus (pGDM) have a high risk of developing postpartum type 2 diabetes mellitus (T2DM). This study aimed to analyze the relationship between lactation, BMI, and TCF7L2 polymorphisms in the conversion to T2DM in women with pGDM. One hundred and fifty-three women con pGDM were recruited from public hospitals of León Guanajuato México. Three groups: normal glucose tolerance (NGT), impaired glucose intolerance (IGT), and T2DM after the oral glucose tolerance test were formed. Metabolic and hormone variables were measured, and genotyping was made by PCR-RFLP. The questionnaire included data on lactation (yes/no), duration of lactation, and full lactation. After 35 (21–49) months from the last partum, 54% of women had an NGT, 30.7% IGT, and 15% T2DM. BMI and rs12255372 are associated with the risk of conversion to IGT and T2DM [OR = 1.07 (95% IC 1.0–1.14, p = .041; OR =2.14, 95% IC 1.01–4.55, p = .04 respectively), while the lactation shows a strong protective effects OR = 0.15 (95% IC 0.062–0.39, p = .00007), and an apparent interaction with rs12255372T decreasing the risk in carriers (OR =2.15; 95% IC 0.97–4.7, p = .05). BMI is an independent risk factor of IGT/T2DM development. The lactation shows a strong protective effect and a possible interaction with rs12255372 polymorphism.
摘要
既往患有妊娠期糖尿病(pGDM)的女性有产后患2型糖尿病(T2DM)的高风险。此项研究目的是分析哺乳期, BMI和TCF7L2基因多态性与既往妊娠期糖尿病患者转化为2型糖尿病之间的关系。从墨西哥瓜纳华托列昂公立医院共招募了153名既往患有妊娠期糖尿病的女性。依据口服糖耐量试验结果分为3组:糖耐量正常组(NGT), 糖耐量受损组(IGT), T2DM组。测量代谢和激素水平指标, 通过用聚合酶链反应-限制性片段长度多态性方法(PCR-RFLP)进行基因分型。调查问卷包括哺乳期(是/否)、哺乳期的持续时间和整个哺乳期的数据。从产后开始35(21-49)个月后, NGT组占54%, IGT组占30.7%, T2DM组占15%。BMI 和rs12255372与转化为IGT和T2DM的风险相关[OR=1.07 (分别95% IC 1.0-1.14, p=.041; OR = 2.14, 95% IC 1.01-4.55, p = .04 )]。而哺乳期表现出很强的保护性作用OR=0.15 (95% IC 0.062=0.39, p=.00007), 并且在携带rs12255372T基因的患者中显示相互作用降低患病风险(OR =2.15; 95% IC 0.97=4.7, p=.05)。BMI是发展为IGT/T2DM的独立危险因素, 哺乳期显示出很强的保护作用, 并可能与rs12255372基因多态性之间相互影响。
The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
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Acknowledgements
We thank the General Hospital and Maternal-Infant Hospital of Health Ministry in León Guanajuato, Health Ministry of Guanajuato, México.
Disclosure statement
The authors state that there is no direct or indirect conflict of interest.