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Postpregnancy BMI in the Progression From Hypertensive Disorders of Pregnancy to Type 2 Diabetes

Timpka, Simon LU ; Stuart, Jennifer J; Tanz, Lauren J; Hu, Frank B; Franks, Paul W LU and Rich-Edwards, Janet W (2019) In Diabetes Care 42(1). p.44-49
Abstract

OBJECTIVE: To study the extent to which BMI after pregnancy adds to the elevated risk of postpregnancy type 2 diabetes in women with a history of hypertensive disorders of pregnancy (HDP) (preeclampsia or gestational hypertension).

RESEARCH DESIGN AND METHODS: We used data from the Nurses' Health Study II, a prospective cohort study. In women aged 45-54 years without prior gestational diabetes mellitus, we investigated the interaction between BMI and HDP history on the risk of type 2 diabetes. For clinical and public health relevance, we focused on additive interaction. The main outcome measure was the relative excess risk due to interaction calculated from multivariable Cox proportional hazards models using normal weight as the... (More)

OBJECTIVE: To study the extent to which BMI after pregnancy adds to the elevated risk of postpregnancy type 2 diabetes in women with a history of hypertensive disorders of pregnancy (HDP) (preeclampsia or gestational hypertension).

RESEARCH DESIGN AND METHODS: We used data from the Nurses' Health Study II, a prospective cohort study. In women aged 45-54 years without prior gestational diabetes mellitus, we investigated the interaction between BMI and HDP history on the risk of type 2 diabetes. For clinical and public health relevance, we focused on additive interaction. The main outcome measure was the relative excess risk due to interaction calculated from multivariable Cox proportional hazards models using normal weight as the reference group.

RESULTS: In total, 6,563 (11.7%) of 56,159 participants had a history of HDP and 1,341 women developed type 2 diabetes during 436,333 person-years. BMI was a strong risk factor for type 2 diabetes regardless of HDP history. However, there was evidence of an additive interaction between BMI and HDP for the risk of type 2 diabetes (P = 0.004). The attributable proportion of risk due to the interaction ranged from 0.12 (95% CI -0.22, 0.46) in women who were overweight to 0.36 (95% CI 0.13, 0.59) in women with obesity class I.

CONCLUSIONS: Maintaining a healthy weight may be of even greater importance in women with a history of HDP, compared with other women with a history of only normotensive pregnancies, to reduce midlife risk of type 2 diabetes.

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Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetes Care
volume
42
issue
1
pages
44 - 49
publisher
American Diabetes Association
external identifiers
  • scopus:85059066188
ISSN
1935-5548
DOI
10.2337/dc18-1532
language
English
LU publication?
yes
id
b370c090-3418-4ae3-b619-50a731c5dfd9
date added to LUP
2018-12-03 21:35:04
date last changed
2019-03-05 03:00:23
@article{b370c090-3418-4ae3-b619-50a731c5dfd9,
  abstract     = {<p>OBJECTIVE: To study the extent to which BMI after pregnancy adds to the elevated risk of postpregnancy type 2 diabetes in women with a history of hypertensive disorders of pregnancy (HDP) (preeclampsia or gestational hypertension).</p><p>RESEARCH DESIGN AND METHODS: We used data from the Nurses' Health Study II, a prospective cohort study. In women aged 45-54 years without prior gestational diabetes mellitus, we investigated the interaction between BMI and HDP history on the risk of type 2 diabetes. For clinical and public health relevance, we focused on additive interaction. The main outcome measure was the relative excess risk due to interaction calculated from multivariable Cox proportional hazards models using normal weight as the reference group.</p><p>RESULTS: In total, 6,563 (11.7%) of 56,159 participants had a history of HDP and 1,341 women developed type 2 diabetes during 436,333 person-years. BMI was a strong risk factor for type 2 diabetes regardless of HDP history. However, there was evidence of an additive interaction between BMI and HDP for the risk of type 2 diabetes (P = 0.004). The attributable proportion of risk due to the interaction ranged from 0.12 (95% CI -0.22, 0.46) in women who were overweight to 0.36 (95% CI 0.13, 0.59) in women with obesity class I.</p><p>CONCLUSIONS: Maintaining a healthy weight may be of even greater importance in women with a history of HDP, compared with other women with a history of only normotensive pregnancies, to reduce midlife risk of type 2 diabetes.</p>},
  author       = {Timpka, Simon and Stuart, Jennifer J and Tanz, Lauren J and Hu, Frank B and Franks, Paul W and Rich-Edwards, Janet W},
  issn         = {1935-5548},
  language     = {eng},
  number       = {1},
  pages        = {44--49},
  publisher    = {American Diabetes Association},
  series       = {Diabetes Care},
  title        = {Postpregnancy BMI in the Progression From Hypertensive Disorders of Pregnancy to Type 2 Diabetes},
  url          = {http://dx.doi.org/10.2337/dc18-1532},
  volume       = {42},
  year         = {2019},
}