产前血糖管理和产后心血管疾病风险查
Rylie Essington1, Jessica Pudwell2, Ravi Retnakaran3
1Queen's University School of Medicine, Kingston Health Sciences Centre, Kingston, ON.
概括
孕期糖尿病 (GDM) 病史的妇女在产后心血管疾病 (CVD) 风险增加. 这种风险随着怀孕期间所需的血糖控制的强度而升级,突出了针对性查的必要性.
科学领域:
- 产科和妇科 产科和妇科
- 心脏病学 心脏病学
- 内分泌学 在内分泌学.
背景情况:
- 孕期糖尿病 (GDM) 是一个重要的妊娠并发症.
- 产后妇女有GDM病史需要评估长期心血管疾病 (CVD) 风险.
- 孕产妇健康诊所 (MHC) 是产后随访和风险评估的关键地点.
研究的目的:
- 在有妊娠糖尿病史的患者中评估心血管疾病 (CVD) 风险概况,这些患者参加母亲健康诊所 (MHC).
- 根据怀孕期间的血糖控制方法 (饮食控制与胰岛素控制的GDM) 来比较心血管疾病风险.
主要方法:
- 对344名患有GDM的产后患者 (165名胰岛素控制,179名饮食控制) 和47名非GDM对照进行了回顾性分析.
- 在产后6个月收集的数据包括人口统计,病史/怀孕史和心血管疾病风险得分.
- 对30年Framingham风险评分和GDM子组和对照组的代谢综合征患病率进行比较.
主要成果:
- 从未暴露组到饮食控制的GDM,然后到胰岛素控制的GDM组,观察到30年Framingham心血管疾病风险得分的显著逐步增加 (P <0.05).
- 代谢综合征的患病率也呈现出显著的逐步增加:16.7% (未暴露),21.5% (饮食控制的GDM) 和44.8% (胰岛素控制的GDM) (P <0.05).
结论:
- 患有GDM的产后妇女表现出心血管疾病 (CVD) 风险因素的患病率增加.
- 在怀孕期间需要进行血糖控制干预的程度与产后心血管疾病风险的大小相关.
- 需要对不同人群进行进一步的研究,以概括血糖控制特定的CVD结果,并优化查策略.
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