Risk for heart disease after gestational diabetes varies with ethnicity
MedWire News: Women's risk for developing cardiovascular disease (CVD) after experiencing gestational diabetes mellitus (GDM) varies according to their ethnicity, say US researchers.
"The prevalence of gestational diabetes is increasing, and its impact for the mother can extend well beyond pregnancy by raising her risk of developing Type 2 diabetes and heart disease," said study author Rhonda Bentley-Lewis (Massachusetts General Hospital, Boston) who presented the results at the Endocrine Society's 93rd Annual Meeting in Boston, USA.
"However, we found that GDM does not confer the same cardiovascular risk to every woman," she added.
In a group of 802 women with GDM and 3208 women without GDM who were followed up for a median of 3.6 years, GDM predicted future CVD (including both cerebrovascular disease and ischemic heart disease) and hypertension in univariate analysis.
But after adjustment for factors such as age, systolic blood pressure, parity, and maternal pregnancy weight gain, multivariate analysis showed that GDM was only a significant predictor of future hypertension (hazard ratio=2.30), but not CVD in the overall cohort.
Being of Black or Hispanic ethnicity were predictors for future CVD in their own right with respective hazard ratios for future CVD of 1.56 and 1.40compared with White ethnicity after adjustment for age, systolic blood pressure, parity, and maternal pregnancy weight gain.
In a stratified analysis taking into account ethnicity and presence of GDM, the team found that Hispanic women with GDM were 70% more likely to develop future CVD than Hispanic women who did not experience GDM. This apparent additive effect of GDM and ethnicity was not observed in Black or White women in the study.
"Hispanic women with gestational diabetes developed heart disease to a greater degree than would be predicted," Bentley-Lewis commented. She explained that further research is needed to find out why this might be the case.
"Physicians should closely monitor women with a history of gestational diabetes, to control their heart disease risk factors," she said. "Their risk for cardiovascular outcomes might differ by race or by factors that we didn't evaluate."
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By Helen Albert