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Epidemiology/Health Services Research
Gestational diabetes and long-term risk for dyslipidemia: a population-based historical cohort study
  1. Gabriel Chodick1,2,
  2. Yaara Tenne3,
  3. Yael Barer1,
  4. Varda Shalev1,2,
  5. Uriel Elchalal3
  1. 1Maccabi Institute Research and Innovation, Maccabi Healthcare Services, Tel Aviv, Israel
  2. 2Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
  3. 3Hadassah University Hospital, Jerusalem, Israel
  1. Correspondence to Dr Gabriel Chodick; hodik_g{at}mac.org.il

Abstract

Objectives To assess the course of lipid levels over time in postpartum women according to gestational diabetes status, taking into account potential confounders, such as comorbid conditions and body weight.

Methods The data for the present analysis were collected from a 2.3 million member integrated care provider in Israel. Included were all female members aged 15–50 years who performed a 50 g glucose challenge test (GCT) between March 1995 and May 2009. We collected all follow-up lipid consecration tests performed from date of delivery following the GCT (index date) until April 2017. Data analysis was performed for each lipid component individually (triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C)) and the effects of the several risk factors (history of gestational diabetes mellitus (GDM), age at delivery, obesity status and smoking status) were investigated using general linear model taking into account potential confounders.

Results A total of 160 527 women (6.1 million person-years of actual follow-up) were eligible for the analysis, including 10 234 women with GDM (6.4% of the entire cohort). During the study follow-up period, a total of 2.1 million lipid tests were performed. When adjusting for follow-up time, age at index date, body mass index status, and smoking status, GDM was associated with a 1.8-fold risk (95% CI 1.73 to 1.88) for dyslipidemia defined by TG, 1.45-fold risk (95% CI 1.38 to 1.52) for dyslipidemia defined by LDL-C, and 1.44-fold risk (95% CI 1.39 to 1.50) for dyslipidemia defined by HDL-C.

Discussion The results of this retrospective cohort analysis indicate that gestational diabetes confers added risk for developing hyperlipidemia post partum, particularly dyslipidemia defined by TG, as compared with women with normal glucose tolerance.

  • gestational diabetes mellitus
  • metabolic syndrome treatment/prevention
  • dyslipidemia
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjdrc-2019-000870

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    Footnotes

    • Contributors UE and GC were responsible for the conception and design and drafting of the article. YT, VS and YB contributed to the analysis or interpretation of study results. All coauthors have provided final approval of the version to be published.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study protocol was approved by the MHS Institutional Review Board for deidentified data studies.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request. According to Israeli regulations, no patient-level secondary used medical data can be publicly shared.