医学
妊娠期糖尿病
荟萃分析
2型糖尿病
糖尿病
相对风险
体质指数
队列研究
产科
内科学
置信区间
怀孕
妊娠期
内分泌学
遗传学
生物
作者
L. Bellamy,Juan-Pablo Casas,Aroon D. Hingorani,David Williams
出处
期刊:The Lancet
[Elsevier]
日期:2009-05-01
卷期号:373 (9677): 1773-1779
被引量:2506
标识
DOI:10.1016/s0140-6736(09)60731-5
摘要
Background Women with gestational diabetes are at increased risk of developing type 2 diabetes, but the risk and time of onset have not been fully quantified. We therefore did a comprehensive systematic review and meta-analysis to assess the strength of association between these conditions and the effect of factors that might modify the risk. Methods We identified cohort studies in which women who had developed type 2 diabetes after gestational diabetes were followed up between Jan 1, 1960, and Jan 31, 2009, from Embase and Medline. 205 relevant reports were hand searched. We selected 20 studies that included 675 455 women and 10 859 type 2 diabetic events. We calculated and pooled unadjusted relative risks (RRs) with 95% CIs for each study using a random-effects model. Subgroups analysed were the number of cases of type 2 diabetes, ethnic origin, duration of follow-up, maternal age, body-mass index, and diagnostic criteria. Findings Women with gestational diabetes had an increased risk of developing type 2 diabetes compared with those who had a normoglycaemic pregnancy (RR 7·43, 95% CI 4·79–11·51). Although the largest study (659 164 women; 9502 cases of type 2 diabetes) had the largest RR (12·6, 95% CI 12·15–13·19), RRs were generally consistent among the subgroups assessed. Interpretation Increased awareness of the magnitude and timing of the risk of type 2 diabetes after gestational diabetes among patients and clinicians could provide an opportunity to test and use dietary, lifestyle, and pharmacological interventions that might prevent or delay the onset of type 2 diabetes in affected women. Funding None.
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