Prediction of women's long-term cardiometabolic risks using glycemic indices during pregnancy
Journal of Obstetrics and Gynaecology Research, 08/16/2012
Tam WH et al. – Women who had a glycemic level below the criteria for a positive screening test and below the diagnostic threshold for GDM still have a significant cardiometabolic risk.Methods
- A cohort of Chinese women who had had either normal glucose tolerance or gestational diabetes mellitus (GDM) during a pregnancy were assessed at a median of 8 and 15 years post–delivery.
- All women underwent a 50–g glucose challenge test (GCT) and a 75–g oral glucose tolerance test in the mid–trimester of the index pregnancy.
- A receiver operating characteristic curve was used to assess the prediction of AGT, DM, HT and MetS.
- All glycemic indices were significant predictors of AGT and DM, and the 2–h plasma glucose (PG) and GCT were predictive of HT, at both 8 and 15 years post–delivery.
- MetS can only be predicted by the fasting plasma glucose (FPG) and was confined to 15 years post–delivery.
- After adjustment for confounding variables, all glycemic indices were still independent predictors of AGT and DM at both 8 and 15 years post–delivery, except for FPG in predicting DM at 8 years, while only the 2–h PG remains an independent predictor of HT at 15 years.
- The optimal cut–off values for FPG, 2–h PG and GCT are 4.2 mmol/L, 7.2 mmol/L and 7.7 mmol/L, respectively; all are lower than the current cut–off thresholds for the screening and diagnosis of GDM.