孕期糖尿病是否会增加患心血管疾病的风险? 一个门德尔的随机化研究
1Department of Endocrinology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China. helenliangww@zju.edu.cn.
Journal of endocrinological investigation
|November 12, 2023
概括
孕期糖尿病 (GDM) 因果上增加了冠状动脉疾病 (CAD) 的风险. 这种联系不依赖于2型糖尿病的存在,突显了在有GDM病史的妇女中需要主动的心血管护理的需要.
科学领域:
- 心血管疾病流行病学
- 生殖内分泌学 生殖内分泌学
- 遗传流行病学遗传流行病学
背景情况:
- 流行病学研究表明,妊娠期糖尿病 (GDM) 和心血管疾病 (CVD) 之间存在联系.
- 需要进一步调查GDM和CVD之间的因果关系.
- 门德尔随机化 (MR) 提供了一个强大的方法来推断因果关系.
研究的目的:
- 使用孟德尔随机化 (MR) 调查GDM对心血管疾病 (CVD) 的潜在因果影响.
- 评估基因预测的GDM与冠状动脉疾病 (CAD) 风险之间的关联.
- 探索2型糖尿病 (T2DM) 在GDM-CAD关系中的调解作用.
主要方法:
- 利用了全基因组关联研究 (GWAS) 的总结统计数据.
- 使用来自FinnGen研究的显著单核酸多态 (SNPs) 进行了MR分析.
- 在一个单独的欧洲祖先群体中进行了CAD的复制分析.
- 使用调解分析来评估潜在的间接影响.
主要成果:
- 基因预测的GDM与增加的CAD风险显著相关 (OR 1.10,95% CI 1.02-1.18).
- 复制分析证实在另一欧洲人群中GDM和CAD之间存在显著的遗传关联 (OR1.07,95%CI1.02-1.12).
- 2型糖尿病 (T2DM) 并没有显著调解GDM和CAD之间的关系.
结论:
- 患有GDM史的女性在未来患有CAD的风险较高.
- 这种增加的CAD风险不仅仅是通过T2DM的后续发展来解释的.
- 常规的CAD风险评估和初级预防对于有GDM病史的女性至关重要.
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