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Translator: Deng Yujie, The Affiliated Hospital of Qingdao University
Introduction: From September 19 to 23, 2022, the international conference in the field of endocrinology "2022 European Association for Diabetes Research Annual Meeting" was held
in Stockholm, Sweden in the form of "online + offline".
At the meeting, scholars shared a study entitled "Prevalence of gestational diabetes in women with a family history of type 2 diabetes in first- and second-degree relatives"
.
Family history of T2DM in primary and secondary relatives correlates with the risk of GDM
A family history of type 2 diabetes mellitus (T2DM) significantly increases an individual's lifetime risk of
developing the disease.
For gestational diabetes mellitus (GDM), the characteristics of this risk factor are less clear, but may play an important role
.
The purpose of this study was to investigate the relationship between the family history of T2DM in female first- and second-degree relatives and the diagnosis of GDM, and also to assess differences
in metabolic characteristics in women with and without a family history of T2DM in the first trimester.
This prospective cohort study included 1164 pregnant women
.
Extensive risk assessment is carried out before 16+0 weeks' gestation, including assessment of maternal characteristics, detailed family history of different types of diabetes, and laboratory tests
for glycometabolism indicators.
First-degree relatives are defined as parents or siblings of pregnant women, and second-degree relatives are defined as grandparents, aunts and uncles
.
Subjects were followed up to delivery and GDM was evaluated
according to the latest diagnostic criteria of the World Health Organization.
Statistical analysis of continuous variables is summarized
by mean± standard deviation or median and IQR (in case of skewed distribution).
These are compared
by analysis of variance or rank-based inference.
Categorical variables are summarized by counts and percentages and compared
by binomial logistic regression.
In addition, the odds ratio and 95% confidence interval (95% CI) of the binary result are calculated
.
The Tukey Honest Significant Difference (HSD) test was used for all subgroup (k=4) comparisons to achieve 95% coverage
.
Statistical analysis
is performed using the R language (version 4.
0.
2) and contribution packages (especially "multcomP" and "nParcomP").
The bilateral p-value ≤0.
05 is considered statistically significant
.
Family history of T2DM is an important risk factor for GDM
The study found:
➤ First-degree relative (FHD1) (n=51,26.
6% (OR1.
91, 95%CI 1.
16-3.
16, P=0.
005), second-degree relative (FHD2) (n=57,26.
3% (OR1.
88, 95% CI 1.
16-3.
05, P=0.
005), or first- and second-degree relatives (FHD1+D2) all had T2DM (n=31,33.
3% (OR2.
64, 95%CI 1.
41-4.
94, P).
<0.
001) The risk of GDM was significantly increased
compared with pregnant women with a negative family history (FHN) (n=100, 15.
9%).
This association is strongest if both parents have a family history of diabetes (OR4.
69, 95% CI 1.
33 to 16.
55, P=0.
009).
➤ Compared with FHN women, almost all the characteristic indicators of glucose metabolism in FHD1 and FHD1+D2 women are poor, except for HDL-cholesterol
.
In addition, in the first trimester of pregnancy, women with FHD1 and FHD1+D2 already experienced impaired insulin action and higher blood glucose levels
at the time of diagnostic OGTT tests compared to women with FHN.
Summary of this article
The study confirms that a family history of T2DM is an important risk factor
for GDM when current diagnostic criteria are applied.
In addition, we confirm that kinship closeness plays an important role
in quantifying risk.
Future research should develop more tools available to predict GDM and add kinship affinity
when risk stratification considers T2DM family history.
Introduction of translators
Deng Yujie
Doctor of Endocrinology
Graduated from Ruijin Hospital affiliated to Shanghai Jiao Tong University, he has been engaged in basic and clinical work related to endocrine and metabolic diseases
He presided over the National Natural Science Foundation of China Youth Project, Shandong Natural Science Foundation Youth Project, Qingdao Postdoctoral Applied Research Project, and Shandong Geriatrics Association Science and Technology Public Program Project
He has published more than 10 SCI articles as the corresponding author, the first author and the co-first author, and applied for 1 international invention patent and 1 national invention patent (both first).
Good at diabetes, obesity, osteoporosis, adrenal, thyroid and other related diseases in the diagnosis and treatment
.