PDF(Pubmed)
Abstract：
Women with migration background present specific challenges related to risk stratification and care of gestational diabetes mellitus (GDM). Therefore, this study aims to investigate the role of ethnic origin on the risk of developing GDM in a multiethnic European cohort.
Pregnant women were included at a median gestational age of 12.9 weeks and assigned to the geographical regions of origin: Caucasian Europe (n = 731), Middle East and North Africa countries (MENA, n = 195), Asia (n = 127) and Sub-Saharan Africa (SSA, n = 48). At the time of recruitment maternal characteristics, glucometabolic parameters and dietary habits were assessed. An oral glucose tolerance test was performed in mid-gestation for GDM diagnosis.
Mothers with Caucasian ancestry were older and had higher blood pressure and an adverse lipoprotein profile as compared to non-Caucasian mothers, whereas non-Caucasian women (especially those from MENA countries) had a higher BMI and were more insulin resistant. Moreover, we found distinct dietary habits. Non-Caucasian mothers, especially those from MENA and Asian countries, had increased incidence of GDM as compared to the Caucasian population (OR 1.87, 95%CI 1.40 to 2.52, p < 0.001). Early gestational fasting glucose and insulin sensitivity were consistent risk factors across different ethnic populations, however, pregestational BMI was of particular importance in Asian mothers.
Prevalence of GDM was higher among women from MENA and Asian countries, who already showed adverse glucometabolic profiles at early gestation. Fasting glucose and early gestational insulin resistance (as well as higher BMI in women from Asia) were identified as important risk factors in Caucasian and non-Caucasian patients.
Pregnant women were included at a median gestational age of 12.9 weeks and assigned to the geographical regions of origin: Caucasian Europe (n = 731), Middle East and North Africa countries (MENA, n = 195), Asia (n = 127) and Sub-Saharan Africa (SSA, n = 48). At the time of recruitment maternal characteristics, glucometabolic parameters and dietary habits were assessed. An oral glucose tolerance test was performed in mid-gestation for GDM diagnosis.
Mothers with Caucasian ancestry were older and had higher blood pressure and an adverse lipoprotein profile as compared to non-Caucasian mothers, whereas non-Caucasian women (especially those from MENA countries) had a higher BMI and were more insulin resistant. Moreover, we found distinct dietary habits. Non-Caucasian mothers, especially those from MENA and Asian countries, had increased incidence of GDM as compared to the Caucasian population (OR 1.87, 95%CI 1.40 to 2.52, p < 0.001). Early gestational fasting glucose and insulin sensitivity were consistent risk factors across different ethnic populations, however, pregestational BMI was of particular importance in Asian mothers.
Prevalence of GDM was higher among women from MENA and Asian countries, who already showed adverse glucometabolic profiles at early gestation. Fasting glucose and early gestational insulin resistance (as well as higher BMI in women from Asia) were identified as important risk factors in Caucasian and non-Caucasian patients.
摘要：
■具有迁移背景的女性面临着与妊娠期糖尿病（GDM）的危险分层和护理相关的特定挑战。因此,本研究旨在调查欧洲多种族队列中种族血统在GDM发病风险中的作用.
■孕妇的平均孕龄为12.9周，并被分配到起源地理区域：高加索欧洲（n=731），中东和北非国家(中东和北非国家，n=195),亚洲(n=127)和撒哈拉以南非洲(SSA，n=48）。在招募时的产妇特征，评估糖代谢参数和饮食习惯。在妊娠中期进行口服葡萄糖耐量试验以诊断GDM。
与非白种人母亲相比，具有白种人血统的母亲年龄较大，血压较高，脂蛋白分布不良，而非高加索女性(尤其是MENA国家的女性)的BMI较高,且胰岛素抵抗程度更高.此外，我们发现了不同的饮食习惯。非白人母亲,特别是来自中东和北非和亚洲国家的，与白种人相比，GDM的发病率增加（OR1.87，95CI1.40至2.52，p<0.001）。早期妊娠空腹血糖和胰岛素敏感性是不同种族人群一致的危险因素。然而,孕前BMI在亚洲母亲中尤为重要.
■MENA和亚洲国家的女性GDM患病率较高，在妊娠早期已经表现出不良的糖代谢特征。空腹血糖和早期妊娠胰岛素抵抗（以及亚洲女性较高的BMI）被认为是白种人和非白种人患者的重要危险因素。
■孕妇的平均孕龄为12.9周，并被分配到起源地理区域：高加索欧洲（n=731），中东和北非国家(中东和北非国家，n=195),亚洲(n=127)和撒哈拉以南非洲(SSA，n=48）。在招募时的产妇特征，评估糖代谢参数和饮食习惯。在妊娠中期进行口服葡萄糖耐量试验以诊断GDM。
与非白种人母亲相比，具有白种人血统的母亲年龄较大，血压较高，脂蛋白分布不良，而非高加索女性(尤其是MENA国家的女性)的BMI较高,且胰岛素抵抗程度更高.此外，我们发现了不同的饮食习惯。非白人母亲,特别是来自中东和北非和亚洲国家的，与白种人相比，GDM的发病率增加（OR1.87，95CI1.40至2.52，p<0.001）。早期妊娠空腹血糖和胰岛素敏感性是不同种族人群一致的危险因素。然而,孕前BMI在亚洲母亲中尤为重要.
■MENA和亚洲国家的女性GDM患病率较高，在妊娠早期已经表现出不良的糖代谢特征。空腹血糖和早期妊娠胰岛素抵抗（以及亚洲女性较高的BMI）被认为是白种人和非白种人患者的重要危险因素。
