Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study

Hakkarainen, Heidi; Huopio, Hanna; Cederberg, Henna; Voutilainen, Raimo; Heinonen, Seppo

doi:10.1186/s12884-018-1958-z

Cited by 13 publications

(9 citation statements)

References 20 publications

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“…The prevalence of MetS nearly doubled (both for MetS-BMI and MetS-WC definitions) in early and late PP. Our results are in line with previous, mostly older cohorts, but show a higher MetS prevalence range 9–14 40…”

Section: Discussionsupporting

confidence: 93%

“…GDM is linked to a two-fold risk of coronary artery calcification7 or future cardiovascular (CV) events8 independently of the development of diabetes 7 8. Earlier studies reported a 15%–20% increase in the prevalence of the metabolic syndrome (MetS) in the early PP (6–8 weeks) and up to 40%–50% in the later years 9–15. The presence of MetS is associated with a 3–4 fold increased risk of CV disease and all-cause mortality 16.…”

Section: Introductionmentioning

confidence: 99%

“…7 8 Earlier studies reported a 15%-20% increase in the prevalence of the metabolic syndrome (MetS) in the early PP (6-8 weeks) and up to 40%-50% in the later years. [9][10][11][12][13][14][15] The presence of MetS is associated with a 3-4 fold increased risk of CV disease and all-cause mortality. 16 Published data are often limited to the evolution of MetS as a whole entity, without mentioning its components or the trajectory of specific body mass index (BMI) categories.…”

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confidence: 99%

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Adverse metabolic outcomes in the early and late postpartum after gestational diabetes are broader than glucose control

Kosinski

Rossel

Gross

et al. 2021

BMJ Open Diab Res Care

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IntroductionGestational diabetes mellitus is associated with an increased cardiovascular risk. To better target preventive measures, we performed an in-depth characterization of cardiometabolic risk factors in a cohort of women with gestational diabetes in the early (6–8 weeks) and late (1 year) postpartum.Research design and methodsProspective cohort of 622 women followed in a university gestational diabetes clinic between 2011 and 2017. 162 patients who attended the late postpartum visit were analyzed in a nested long-term cohort starting in 2015. Metabolic syndrome (MetS) was based on the International Diabetes Federation definition, and then having at least two additional criteria of the MetS (blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol, plasma glucose above or below the International Diabetes Federation cut-offs).ResultsCompared with prepregnancy, weight retention was 4.8±6.0 kg in the early postpartum, and the prevalence of obesity, pre-diabetes, MetS-body mass index (BMI) and MetS-waist circumference (WC) were 28.8%, 28.9%, 10.3% and 23.8%, respectively. Compared with the early postpartum, weight did not change and waist circumference decreased by 2.6±0.6 cm in the late postpartum. However, the prevalence of obesity, pre-diabetes, MetS-WC and MetS-BMI increased (relative increase: 11% for obesity, 82% for pre-diabetes, 50% for MetS-WC, 100% for MetS-BMI; all p≤0.001).Predictors for obesity were the use of glucose-lowering treatment during pregnancy and the prepregnancy BMI. Predictors for pre-diabetes were the early postpartum fasting glucose value and family history of diabetes. Finally, systolic blood pressure in pregnancy and in the early postpartum, the 2-hour post oral glucose tolerance test glycemia and the HDL-cholesterol predicted the development of MetS (all p<0.05).ConclusionsThe prevalence of metabolic complications increased in the late postpartum, mainly due to an increase in fasting glucose and obesity, although weight did not change. We identified predictors of late postpartum obesity, pre-diabetes and MetS that could lead to high-risk identification and targeted preventions.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Adverse metabolic outcomes in the early and late postpartum after gestational diabetes are broader than glucose control

Kosinski

Rossel

Gross

et al. 2021

BMJ Open Diab Res Care

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“…Different criteria, however, are being used to classify the syndrome during pregnancy and in the postpartum period, when the abdominal circumference is significantly changed. [2][3][4]…”

Section: Introductionmentioning

confidence: 99%

Metabolic syndrome in pregnancy and postpartum: prevalence and associated factors

Lima

Melo²,

Sena

et al. 2019

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE Evaluate the prevalence of metabolic syndrome (MS) and the main associated maternal factors in women without pre-gestational conditions, in early pregnancy and in the immediate postpartum. METHODS Two hundred pregnant women were evaluated at the 16th week of pregnancy, and 187 were reassessed postpartum. MS was diagnosed according to the criteria by the National Cholesterol Education Program Adult Treatment Panel III. In addition to the diagnostic criteria, anthropometric measures, blood pressure, metabolic profile, and visceral and subcutaneous fat thickness (by ultrasonography) were collected from the pregnant woman. The student’s t-test was used to compare the prevalence of MS and its components in the 16th week and in the postpartum. Multiple logistic regression was performed to identify the principal factors associated with the syndrome. RESULTS The prevalence of the MS was 3.0% in early pregnancy and 9.7% postpartum (p=0.01). Following multiple logistic regression, the prepregnancy body mass index (BMI) (p=0.04) and high-density lipoprotein cholesterol (HDL-c) (p=0.02) remained associated with MS at 16 weeks, and triglyceride levels evaluated in postpartum (p<0.001) with MS in postpartum. CONCLUSION The frequency of the MS was high in the immediate postpartum. The factors associated were prepregnancy BMI and HDL-c at the 16th week, as well as triglyceride levels postpartum.

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“…The presence of Acanthosis Nigricans on the neck has been shown to be a reliable clinical indicator of insulin resistance (IR), an important component of MetS (11). In addition, in males there is a strong association between MetS and erectile dysfunction (12); and in females, between MetS and maternal body mass index (BMI) and fetal macrosomia (13). Lastly, other anthropometric measurements, such as the waist-to-height ratio, have been correlated with MetS (14).…”

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confidence: 99%

Validation of a non-laboratorial questionnaire to identify Metabolic Syndrome among a population in central Mexico

Porchia

Lara-Solis

Torres‐Rasgado

et al. 2019

Rev Panam Salud Publica

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Objective To determine the reliability of a non-laboratorial questionnaire, the Encuesta de Identificación de Sujetos Metabólicamente Comprometidos en Fase-I (ESF-I) for identifying Metabolic Syndrome among a population in central Mexico. Methods Clinical and biochemical parameters were collected for 232 participants from 1 June 2012 – 31 August 2013. Three definitions of Metabolic Syndrome (Harmonizing, National Cholesterol Education Program Expert Panel and Adult Treatment Panel III [ATPIII], and International Diabetes Federation [IDF]) were used to allocate subjects to either the normal or Metabolic Syndrome positive (MetS+) group. The predictability of the questionnaire was determined by the Area-Under-the-Receiver-Operating Characteristic curve (AUC). Youden's index was calculated and the highest score was considered the optimal cutoff value. Cohen´s kappa (κ) was calculated to determine the level of agreement between the ESF-I questionnaire (max score: 15 based on 15 items) and Metabolic Syndrome. Results From 53.8% – 60.7% of the participants were determined to be MetS+. The average questionnaire score was significantly higher in the MetS+ group for each definition (4.0 vs. 8.0, P < 0.05). The ESF-I questionnaire was predictive for the Harmonizing definition (AUC = 0.841, 95%CI: 0.790 – 0.892), the ATPIII definition (AUC = 0.827, 95%CI: 0.774 – 0.880), and the IDF definition (AUC = 0.836, 95%CI: 0.785 – 0.887). A cutoff value of 7 was determined for each definition; therefore, the cohort was re-categorized based on questionnaire results. There was a strong agreement between the ESF-I questionnaire and MetS (Harmonizing: accuracy = 77.6%, κ = 0.554; ATPIII: accuracy = 74.1%, κ = 0.489; IDF: accuracy = 74.6%, κ = 0.495, P < 0.001). Conclusion The ESF-I questionnaire can identify MetS+ patients, and therefore, lead to earlier diagnoses, reduced number of consultations, and lower costs with easier application.

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Future risk of metabolic syndrome in women with a previous LGA delivery stratified by gestational glucose tolerance: a prospective cohort study

Cited by 13 publications

References 20 publications

Adverse metabolic outcomes in the early and late postpartum after gestational diabetes are broader than glucose control

Adverse metabolic outcomes in the early and late postpartum after gestational diabetes are broader than glucose control

Metabolic syndrome in pregnancy and postpartum: prevalence and associated factors

Validation of a non-laboratorial questionnaire to identify Metabolic Syndrome among a population in central Mexico

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