Cardiovasc diabetol: long-term cardiovascular outcomes of gestational diabetes

Previous studies have suggested that gestational diabetes may be a risk factor
for subsequent atherosclerotic cardiovascular disease.
However, there is limited
information on different cardiovascular outcomes following gestational diabetes in older women.

Recently, Cardiovasc Diabetol, an authoritative journal in the field of cardiovascular and metabolic diseases, published a research article in which researchers aimed to assess whether women with a history of gestational diabetes had an increased
risk of long-term overall cardiovascular outcomes.

Among the UK participants, the researchers included 219,330 women aged 40 to 69 who reported at least one live birth
.
The incidence
of different cardiovascular outcomes was compared using a multivariate Cox proportional hazards model based on a history of gestational diabetes.
In addition, the researchers performed causal-mediated analyses to assess the role of
known risk factors in observing risk.

After registration, 13,094 women (6.
0%) experienced new global cardiovascular outcomes
.
Women with a history of gestational diabetes had an increased risk of overall cardiovascular outcomes [adjusted HR (aHR) 1.
36 (95% CI 1.
18 to 1.
55)] after adjusting for age, race, BMI, smoking, early menopause, hysterectomy, epidemic disease, and medical therapy, including coronary artery disease [aHR 1.
31 (1.
08 to 1.
59)], myocardial infarction [aHR 1.
65 (1.
27 to 2.
15)], and ischaemic stroke [aHR 1.
68].
(1.
18-2.
39)], peripheral arterial disease [aHR 1.
69 (1.
14-2.
51)], heart failure [aHR 1.
41 (1.
06-1.
87)], mitral regurgitation [aHR 2.
25 (1.
51-3.
34)], and atrial fibrillation/flutter [aHR 1.
47 (1.
18-1.
84)].

In mediated analyses, overt diabetes explained 23%, hypertension explained 11%, and dyslipidemia explained 10% of the association
between gestational diabetes and overall cardiovascular outcomes.

Gestational diabetes is associated with more diverse cardiovascular outcomes than previously thought, with traditional risk factors such as diabetes, hypertension and dyslipidemia contributing to some extent
.

Original source:

Seung Mi Lee.
et al.
Long-term cardiovascular outcomes of gestational diabetes mellitus: a prospective UK Biobank study.
Cardiovasc Diabetol.
2022.
https://cardiab.
biomedcentral.
com/articles/10.
1186/s12933-022-01663-w