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Metabolic and polycystic ovary syndromes in indigenous South Asian women with previous gestational diabetes mellitus

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Abstract:

Objective

To determine the risk of metabolic syndrome (MS) and polycystic ovary syndrome (PCOS) in a cohort of indigenous South Asian women with a recent history of gestational diabetes mellitus (GDM). Design

Case–control study. Setting

Department of Obstetrics & Gynaecology, University of Colombo, Sri Lanka. Sample

Two hundred and seventy-four indigenous Sri Lankan women with previous GDM and 168 ethnically matched controls. Of these, 147 with previous GDM and 67 controls not taking hormonal contraception participated in an in-depth endocrine study. Methods

Assessing the prevalence of MS and PCOS based on clinical features, biochemistry and ovarian ultrasound examination at 3 years postpartum. Main outcome measures

Prevalence of MS and PCOS. Results

Women with previous GDM and controls were studied at a mean (range) of 34.6 (13.4–84.1) and 46.5 (17.5–78) months postpartum, respectively. Those with previous GDM had a larger mean ± 95% confidence interval waist circumference (90.9 ± 1.3 versus 81.2 ± 2.8 cm, P= 0.0004) and were more likely to have hypertension (17.6 versus 7.4%, P= 0.001), glucose intolerance (51.7 versus 10.4%, P= 0.00001), hypertriglyceridaemia (16.3 versus 5.9%, P= 0.02) and a lower level of high-density lipoprotein (70 versus 56.7%, P= 0.04) than the controls. Of the women who had GDM, 72 (49%) had MS, 86 (58.5%) had polycystic ovaries and 59 (40%) had PCOS, significantly more than the control women—4 (6%), 9 (13%) and 2 (3%), respectively (P= 0.00001). Conclusions

The prevalence of MS and PCOS in indigenous Sri Lankan women 3 years postpartum is significantly higher in those with previous GDM compared with ethnically matched controls. This confirms an association between GDM and subsequent PCOS and MS.

Keywords: Gestational diabetes; metabolic syndrome; obesity; polycystic ovary syndrome

Document Type: Research Article

DOI: http://dx.doi.org/10.1111/j.1471-0528.2006.01046.x

Affiliations: 1: Department of Obstetrics & Gynaecology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka 2: Department of Obstetrics & Gynaecology, The General Infirmary at Leeds, Leeds, UK

Publication date: October 1, 2006

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