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Overweight, obesity and hyperandrogenemia are associated with gestational diabetes mellitus: A follow-up cohort study.

Authors
  • West, Sammeli1
  • Ollila, Meri-Maija1
  • Franks, Stephen2
  • Piltonen, Terhi1
  • Jokelainen, Jari3, 4
  • Nevalainen, Jaana1
  • Puukka, Katri5
  • Ruokonen, Aimo5
  • Järvelin, Marjo-Riitta6, 7
  • Auvinen, Juha3, 4
  • Tapanainen, Juha S1, 8
  • Morin-Papunen, Laure1
  • 1 Department of Obstetrics and Gynecology, Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Oulu, Finland. , (Finland)
  • 2 Institute of Reproductive and Developmental Biology, Imperial College London, London, UK.
  • 3 Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland. , (Finland)
  • 4 Unit of General Practice, Oulu University Hospital, Oulu, Finland. , (Finland)
  • 5 Department of Clinical Chemistry, NordLab Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland. , (Finland)
  • 6 Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland. , (Finland)
  • 7 Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Center for Environment and Health, School of Public Health, Imperial College London, London, UK.
  • 8 Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. , (Finland)
Type
Published Article
Journal
Acta Obstetricia Et Gynecologica Scandinavica
Publisher
Wiley (Blackwell Publishing)
Publication Date
Oct 01, 2020
Volume
99
Issue
10
Pages
1311–1319
Identifiers
DOI: 10.1111/aogs.13883
PMID: 32333801
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The aim of the study was to determine the association of body mass index (BMI), self-reported symptoms or diagnosis of polycystic ovary syndrome (PCOS), and hyperandrogenemia with the occurrence of gestational diabetes mellitus (GDM) through reproductive life. A cohort of women born in 1966 were investigated at ages 14, 31 and 46. Women with self-reported PCOS symptoms (presence of both oligo-amenorrhea and hirsutism) at age 31 or with formally diagnosed polycystic ovaries (PCO)/PCOS by age 46 formed the group of self-reported PCOS (srPCOS, n = 222) and were compared with women without self-reported PCOS symptoms or diagnosis (n = 1357). We investigated also the association of hyperandrogenism (hirsutism or biochemical hyperandrogenism) at age 31 with the occurrence of GDM throughout reproductive life. Self-reported PCOS alone was not a risk factor for GDM, but combined with overweight at age 31 (odds ratio [OR] 2.43, 95% confidence interval [CI] 1.22-4.86) or 46 (OR 3.04, 95% CI 1.58-5.83) srPCOS was associated with GDM when compared with normal weight controls. The association disappeared when comparing overweight srPCOS women with overweight controls. However, hyperandrogenemia at age 31, but not hirsutism, was associated with GDM even after adjustment for BMI. The increased risk of GDM in women with srPCOS was mostly attributed to overweight or obesity. Importantly, normal weight women with srPCOS did not seem to be at increased risk for developing GDM. However, hyperandrogenemia was associated with GDM even after adjustment for BMI. These findings strengthen the importance of weight management in reproductive-age women and suggest a noteworthy role of hyperandrogenemia in the pathophysiology of GDM. © 2020 Nordic Federation of Societies of Obstetrics and Gynecology.

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