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Preterm Delivery and Metabolic Syndrome in Women Followed From Prepregnancy Through 25 Years Later.

ABSTRACT: OBJECTIVE:To investigate whether women who deliver preterm have excess risk for metabolic dysregulation independent of prepregnancy factors. METHODS:We conducted a multicenter, longitudinal, observational study of 1,205 women (50% black) in the Coronary Artery Risk Development in Young Adults study with at least one birth between baseline (1985-1986) and year 25 and no metabolic syndrome or diabetes before pregnancy. Cardiometabolic factors were measured prepregnancy and at up to five subsequent examinations. We estimated the relative hazards of incident metabolic syndrome in women with one or more preterm births (less than 37 weeks of gestation, n=295) compared with only term births (37 weeks of gestation or greater, n=910). Self-reported gestational diabetes mellitus, hypertension during pregnancy, and time-dependent weight gain were also considered as covariates. RESULTS:Of 315 cases of metabolic syndrome in 17,717 person-years of follow-up, the incidence rate was higher among women with preterm compared with term births (22.0 compared with 16.4 per 1,000 person-years; relative hazard 2.91 [95% confidence interval (CI) 2.75-3.09]). After adjustment for prepregnancy cardiometabolic factors and covariates, the relative hazard (95% CI) for metabolic syndrome was 1.52 (1.22-1.88) for women with preterm compared with term births. Gestational diabetes mellitus, hypertension during pregnancy, and weight gain only modestly attenuated this association. Elevated blood pressure (36.3% compared with 26.7%, P=.002) and central adiposity (51.5% compared with 44.0%, P=.02) were the individual metabolic syndrome components that were different in women with preterm compared with term births. CONCLUSION:Women with a history of preterm birth have increased risk of incident metabolic syndrome compared with those with term births, independent of the prepregnancy metabolic status and pregnancy complications.

SUBMITTER: Catov JM

PROVIDER: S-EPMC4879053 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Preterm Delivery and Metabolic Syndrome in Women Followed From Prepregnancy Through 25 Years Later.

Catov Janet M JM Althouse Andrew D AD Lewis Cora E CE Harville Emily W EW Gunderson Erica P EP

Obstetrics and gynecology 20160601 6

<h4>Objective</h4>To investigate whether women who deliver preterm have excess risk for metabolic dysregulation independent of prepregnancy factors.<h4>Methods</h4>We conducted a multicenter, longitudinal, observational study of 1,205 women (50% black) in the Coronary Artery Risk Development in Young Adults study with at least one birth between baseline (1985-1986) and year 25 and no metabolic syndrome or diabetes before pregnancy. Cardiometabolic factors were measured prepregnancy and at up to ...[more]

PMID: 27159748

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Project description:ObjectiveTo analyze the associations between serum 25(OH)D levels and the risk of metabolic syndrome (MetS) and its components, and the related genetic and non-genetic factors in non-diabetic women of childbearing age in China.MethodsSubjects were randomly selected from the 2015 Chinese Adult Chronic Disease and Nutrition Surveillance. The data of sociodemographic characteristics and lifestyle factors were obtained through questionnaire survey. Anthropometry was measured by trained interviewers, and fasting blood was collected to test 25-hydroxyvitamin D [25(OH)D], total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), and other related parameters. Generalized linear mode and multivariate logistic analysis were performed to analyze the associations between serum 25(OH)D and MetS and its components, adjusting for the possible confounders.ResultsBody mass index (BMI), serum alanine aminotransferase (ALT), hypersensitive C-reactive protein (hs-CRP), 25(OH)D, phosphorus (P), and parathyroid hormone (PTH) levels were associated with the number of MetS's components. G allele carriers of GC rs2282679 had higher diastolic blood pressure (DBP) and FBG levels compared with the TT genotypes, while higher genetic risk score (GRS) seemed to be associated with reduced HDL-C level. The odds ratio (OR) for MetS in lowest group of 25(OH)D was 1.533 (0.980-2.399) after adjusting for season, district, area type, latitude, age, BMI, PTH, P, ALT, CRE, interleukin-6 (IL-6), and hs-CRP, compared with the median group, but the association was not significant. An insufficient 25(OH)D concentration (<14.22 ng/mL) was significantly related to the risk of elevated waist circumference (WC) (OR = 1.612 (1.014-2.561)) and TG (OR = 2.210 (1.318-3.706)), and reduced HDL-C (OR = 1.639 (1.206-2.229)) after adjusting for the confounders among these women. Moreover, these relationships were not affected by vitamin D metabolism-related gene polymorphisms.ConclusionAfter comprehensively considering various influencing factors, significant associations between insufficient serum 25(OH)D and MetS's components, including elevated WC, TG, and reduced HDL-C, were observed. However, MetS, hypertension, and hyperglycemia were not found independently associated with 25(OH)D levels.

Project description:Low concentrations of serum 25-hydroxyvitamin D [25(OH)D] may be associated with cardiometabolic disorders; however, little is known about their relation to intermediate metabolic and lipid markers.We investigated the relation of serum 25(OH)D concentrations to fasting insulin, glucose, dyslipidemia, adiposity, and prevalent metabolic syndrome.We conducted this cross-sectional analysis in 292 postmenopausal women aged 50-79 y in the Women's Health Initiative Calcium-Vitamin D (WHI-CaD) trial. Data were collected from 3 nested case-control studies that measured baseline serum 25(OH)D concentrations. Inverse probability weighting was used to approximate parameter estimates for the WHI-CaD population.In weighted linear regression models adjusted for age, race-ethnicity, month of blood draw, region, case-control status, smoking, alcohol, physical activity, and history of cardiometabolic risk factors, there was an inverse association of serum 25(OH)D with adiposity [body mass index (BMI): ? = -1.12 ± 0.30, P = 0.0002; waist circumference: ? = -3.57 ± 0.49, P < 0.0001; waist-hip ratio: ? = -0.01 ± 0.002, P < 0.0001], triglycerides (? = -0.10 ± 0.02, P < 0.0001), and triglyceride:HDL-cholesterol ratio (? = -0.11 ± 0.03, P = 0.0003). The multivariable-adjusted odds ratio for metabolic syndrome for the highest (?52 nmol/L) compared with the lowest (<35 nmol/L) tertile of serum 25(OH)D concentrations was 0.28 (95% CI: 0.14, 0.56). Significant associations remained after adjustment for BMI. We observed no significant associations with LDL cholesterol, HDL cholesterol, insulin, glucose, homeostatic model assessment of insulin resistance (HOMA-IR), or homeostatic model assessment of ? cell function (HOMA-?).Higher serum 25(OH)D concentrations may be inversely associated with adiposity, triglycerides, triglyceride:HDL-cholesterol ratio, and metabolic syndrome but are not associated with LDL and HDL cholesterol, insulin, glucose, HOMA-IR, or HOMA-? in postmenopausal women. This trial was registered at clinicaltrials.gov as NCT00000611.

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Preterm Delivery and Metabolic Syndrome in Women Followed From Prepregnancy Through 25 Years Later.

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Preterm Delivery and Metabolic Syndrome in Women Followed From Prepregnancy Through 25 Years Later.

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