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Abstract：
BACKGROUND: Studies on the association of gestational diabetes mellitus (GDM) with osteoporosis, and bone mineral density (BMD) have been inconsistent. The aim of this study was to investigate the association of a history of GDM with osteoporosis, BMD, and trabecular bone score (TBS) in postmenopausal women.
METHODS: Postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2010, between 2013 and 2014, and between 2017 and 2018 were retrospectively included in this cross-sectional study. The logistic regression model was used to explore the relationship between GDM and osteoporosis, and a weighted linear regression model was applied to investigate the association between GDM and total femoral BMD, femoral neck BMD, and total TBS. Subgroup analysis of the association between GDM and osteoporosis was performed according to age, body mass index (BMI), and DM (yes or no).
RESULTS: Of the 6732 women included, 253 women (3.76%) had GDM. No significant differences in total femoral BMD, femoral neck BMD, and total TBS were observed between postmenopausal women with and without a history of GDM. However, a history of GDM was associated with a higher risk of osteoporosis in postmenopausal women [odds ratio (OR): 11.18, 95% confidence intervals (CI): 3.64 to 34.27, P < 0.001]. There was no significant difference between a history of GDM and osteoporosis in postmenopausal women whom BMI is normal and overweight women. However, there was an association between a history of GDM and osteoporosis in postmenopausal obese women (OR: 26.57, 95% CI 10.23 to 68.98, P < 0.001).
CONCLUSIONS: A history of GDM was associated with a higher risk of osteoporosis in postmenopausal women, particularly in postmenopausal obese women.
METHODS: Postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2010, between 2013 and 2014, and between 2017 and 2018 were retrospectively included in this cross-sectional study. The logistic regression model was used to explore the relationship between GDM and osteoporosis, and a weighted linear regression model was applied to investigate the association between GDM and total femoral BMD, femoral neck BMD, and total TBS. Subgroup analysis of the association between GDM and osteoporosis was performed according to age, body mass index (BMI), and DM (yes or no).
RESULTS: Of the 6732 women included, 253 women (3.76%) had GDM. No significant differences in total femoral BMD, femoral neck BMD, and total TBS were observed between postmenopausal women with and without a history of GDM. However, a history of GDM was associated with a higher risk of osteoporosis in postmenopausal women [odds ratio (OR): 11.18, 95% confidence intervals (CI): 3.64 to 34.27, P < 0.001]. There was no significant difference between a history of GDM and osteoporosis in postmenopausal women whom BMI is normal and overweight women. However, there was an association between a history of GDM and osteoporosis in postmenopausal obese women (OR: 26.57, 95% CI 10.23 to 68.98, P < 0.001).
CONCLUSIONS: A history of GDM was associated with a higher risk of osteoporosis in postmenopausal women, particularly in postmenopausal obese women.
摘要：
背景：关于妊娠期糖尿病（GDM）与骨质疏松症的关系的研究，和骨矿物质密度（BMD）不一致。这项研究的目的是调查GDM病史与骨质疏松症的关系。BMD,和绝经后妇女的骨小梁评分（TBS）。
方法：从2007年至2010年，2013年至2014年以及2017年至2018年的国家健康与营养检查调查（NHANES）中的绝经后妇女被回顾性纳入本横断面研究。采用logistic回归模型探讨GDM与骨质疏松的关系,并应用加权线性回归模型研究GDM与股骨总骨密度之间的关系，股骨颈BMD,总TBS。根据年龄对GDM与骨质疏松的相关性进行亚组分析,体重指数（BMI），和DM（是或否）。
结果：在包括的6732名妇女中，253名女性（3.76%）患有GDM。股骨总骨密度无显著差异，股骨颈BMD,在有和没有GDM病史的绝经后妇女之间观察到总TBS。然而,GDM病史与绝经后女性骨质疏松症风险较高相关[比值比(OR):11.18,95%置信区间(CI):3.64~34.27,P<0.001].BMI正常的绝经后妇女和超重妇女的GDM病史和骨质疏松症之间没有显着差异。然而,绝经后肥胖女性GDM病史与骨质疏松之间存在相关性(OR:26.57,95%CI10.23~68.98,P<0.001).
结论：GDM病史与绝经后妇女骨质疏松症的高风险相关，尤其是绝经后肥胖女性。
方法：从2007年至2010年，2013年至2014年以及2017年至2018年的国家健康与营养检查调查（NHANES）中的绝经后妇女被回顾性纳入本横断面研究。采用logistic回归模型探讨GDM与骨质疏松的关系,并应用加权线性回归模型研究GDM与股骨总骨密度之间的关系，股骨颈BMD,总TBS。根据年龄对GDM与骨质疏松的相关性进行亚组分析,体重指数（BMI），和DM（是或否）。
结果：在包括的6732名妇女中，253名女性（3.76%）患有GDM。股骨总骨密度无显著差异，股骨颈BMD,在有和没有GDM病史的绝经后妇女之间观察到总TBS。然而,GDM病史与绝经后女性骨质疏松症风险较高相关[比值比(OR):11.18,95%置信区间(CI):3.64~34.27,P<0.001].BMI正常的绝经后妇女和超重妇女的GDM病史和骨质疏松症之间没有显着差异。然而,绝经后肥胖女性GDM病史与骨质疏松之间存在相关性(OR:26.57,95%CI10.23~68.98,P<0.001).
结论：GDM病史与绝经后妇女骨质疏松症的高风险相关，尤其是绝经后肥胖女性。
