Journal article
Gestational Diabetes Mellitus and Renal Function: A Prospective Study With 9- to 16-Year Follow-up After Pregnancy
Diabetes care, Vol.41(7), pp.1378-1384
07/2018
DOI: 10.2337/dc17-2629
PMCID: PMC6014536
PMID: 29728364
Abstract
To examine whether gestational diabetes mellitus (GDM), independent of subsequent diabetes, is an early risk factor for renal impairment long term after the index pregnancy.
In the Diabetes & Women's Health (DWH) study (2012-2016), we examined the independent and joint associations of GDM and subsequent diabetes with long-term renal function among 607 women with and 619 women without GDM in the Danish National Birth Cohort (DNBC) index pregnancy (1996-2002). At median follow-up of 13 years after the index pregnancy, serum creatinine (mg/dL) and urinary albumin (mg/L) and creatinine (mg/dL) were measured, from which estimated glomerular filtration rate (eGFR) (mL/min/1.73 m
) and urinary albumin-to-creatinine ratio (UACR) (mg/g) were derived.
Compared with women without GDM or subsequent diabetes, women with a GDM history had significantly higher eGFR even if they had not subsequently developed diabetes (adjusted β-coefficient [95% CI] = 3.3 [1.7, 5.0]). Women who had a GDM history and later developed diabetes (
= 183) also had significantly higher UACR [exponent β = 1.3 [95% CI 1.1, 1.6]) and an increased risk of elevated UACR (≥20 mg/g) [adjusted relative risk [95% CI] = 2.3 [1.1, 5.9]) compared with women with neither. After adjusting for potential confounders including prepregnancy BMI and hypertension, GDM without subsequent diabetes was not related to UACR.
Women who develop GDM in pregnancy were more likely to show increased eGFR levels 9-16 years postpartum, which could indicate early stages of glomerular hyperfiltration and renal damage. However, only those who subsequently developed diabetes showed overt renal damage as evidenced by elevated UACR.
Details
- Title: Subtitle
- Gestational Diabetes Mellitus and Renal Function: A Prospective Study With 9- to 16-Year Follow-up After Pregnancy
- Creators
- Shristi Rawal - Department of Nutritional Sciences, School of Health Professions, Rutgers University, Newark, NJSjurdur F Olsen - Centre for Fetal Programming, Statens Serum Institut, Copenhagen, DenmarkLouise G Grunnet - The Danish Diabetes Academy, Odense, DenmarkRonald C Ma - Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, ChinaStefanie N Hinkle - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MDCharlotta Granström - Centre for Fetal Programming, Statens Serum Institut, Copenhagen, DenmarkJing Wu - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MDEdwina Yeung - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MDJames L Mills - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MDYeyi Zhu - Division of Research, Kaiser Permanente Northern California, Oakland, CAWei Bao - Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IASylvia H Ley - Department of Nutrition, Harvard T.H. Chan School of Public Health, and Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MAFrank B Hu - Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MAPeter Damm - Center for Pregnant Women with Diabetes, Department of Obstetrics, Rigshospitalet, and Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, DenmarkAllan Vaag - Cardiovascular and Metabolic Disease Translational Medicine Unit, Early Clinical Development, IMED Biotech Unit, AstraZeneca, Gothenburg, SwedenMichael Y Tsai - Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MNCuilin Zhang - Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD zhangcu@mail.nih.gov
- Resource Type
- Journal article
- Publication Details
- Diabetes care, Vol.41(7), pp.1378-1384
- Publisher
- United States
- DOI
- 10.2337/dc17-2629
- PMID
- 29728364
- PMCID
- PMC6014536
- ISSN
- 0149-5992
- eISSN
- 1935-5548
- Grant note
- HHSN275201000020C / NICHD NIH HHS HHSN275201500003C / NICHD NIH HHS HHSN275201300026I / NICHD NIH HHS HHSN275201100002G / NICHD NIH HHS HHSN275201100002C / NICHD NIH HHS
- Language
- English
- Date published
- 07/2018
- Academic Unit
- Epidemiology; Fraternal Order of Eagles Diabetes Research Center
- Record Identifier
- 9983995048502771
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