Gestational Diabetes Mellitus Increases the Risk of Cardiovascular Disease in Women With a Family History of Type 2 Diabetes

  1. Darcy B. Carr, MD, MS1,
  2. Kristina M. Utzschneider, MD2,
  3. Rebecca L. Hull, PHD2,
  4. Jenny Tong, MD, MPH2,
  5. Tara M. Wallace, MD2,
  6. Keiichi Kodama, MD2,
  7. Jane B. Shofer, MS3,
  8. Susan R. Heckbert, MD, PHD45,
  9. Edward J. Boyko, MD, MPH26,
  10. Wilfred Y. Fujimoto, MD2,
  11. Steven E. Kahn, MB, CHB2 and
  12. the American Diabetes Association GENNID Study Group*
  1. 1Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington
  2. 2Division of Metabolism, Endocrinology, and Nutrition, Department of Medicine, VA Puget Sound Health Care System and the University of Washington, Seattle, Washington
  3. 3Department of Rehabilitation Research and Development, University of Washington, Seattle, Washington
  4. 4Department of Epidemiology, University of Washington, Seattle, Washington
  5. 5Cardiovascular Health Research Unit, VA Puget Sound Health Care System, Seattle, Washington
  6. 6Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington
  1. Address correspondence and reprint requests to Darcy B. Carr, MD, MS, Box 356460, University of Washington, Seattle, WA 98195-6460. E-mail:darcarr{at}u.washington.edu

Abstract

OBJECTIVE— We sought to determine whether a history of gestational diabetes mellitus (GDM) further increases the risk of cardiovascular disease (CVD) in parous women with first-degree relatives with type 2 diabetes.

RESEARCH DESIGN AND METHODS— Women with (n = 332) and without (n = 663) a history of GDM were compared regarding 1) the revised National Cholesterol Education Program Adult Treatment Panel III metabolic syndrome criteria, 2) the prevalence of type 2 diabetes, and 3) self-reported CVD.

RESULTS— Women with prior GDM were younger (48.6 ± 0.7 vs. 52.4 ± 0.6 years [means ± SE];P < 0.001) and less likely to be postmenopausal (48.3 vs. 57.9%; P < 0.005). Although both groups were obese (BMI 34.4 ± 1.2 vs. 33.7 ± 0.6 kg/m2), women with prior GDM were more likely to have metabolic syndrome (86.6 vs. 73.5%; P < 0.001) and type 2 diabetes (93.4 vs. 63.3%; P < 0.001). Moreover, they had a higher prevalence of CVD (15.5 vs. 12.4%; adjusted odds ratio 1.85 [95% CI 1.21–2.82];P = 0.005) that occurred at a younger age (45.5 ± 2.2 vs. 52.5 ± 1.9 years;P = 0.02) and was independent of metabolic syndrome (1.74 [1.10–2.76]; P = 0.02) and type 2 diabetes (1.56 [1.002–2.43];P < 0.05).

CONCLUSIONS— Among women with a family history of type 2 diabetes, those with prior GDM were even more likely to not only have CVD risk factors, including metabolic syndrome and type 2 diabetes, but also to have experienced CVD events, which occurred at a younger age. Thus, women with both a family history of type 2 diabetes and personal history of GDM may be especially suitable for early interventions aimed at preventing or reducing their risk of CVD and diabetes.

Footnotes

  • *

    ↵* *The list of centers that comprise the American Diabetes Association GENNID Study Group can be found in ref.24.

    ↵A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.

    ↵The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

    • Accepted May 10, 2006.
    • Received December 16, 2005.
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  1. doi: 10.2337/dc05-2482 Diabetes Care September 2006 vol. 29 no. 9 2078-2083
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