University of Oulu

West, S, Ollila, M‐M, Franks, S, et al. Overweight, obesity and hyperandrogenemia are associated with gestational diabetes mellitus: A follow‐up cohort study. Acta Obstet Gynecol Scand. 2020; 99: 1311– 1319. https://doi.org/10.1111/aogs.13883

Overweight, obesity and hyperandrogenemia are associated with gestational diabetes mellitus : a follow‐up cohort study

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Author: West, Sammeli1; Ollila, Meri‐Maija1; Franks, Stephen2;
Organizations: 1Department of Obstetrics and Gynecology, Medical Research Center Oulu and PEDEGO Research Unit (Research Unit for Pediatrics, Dermatology, Clinical Genetics, Obstetrics and Gynecology, University Hospital of Oulu, University of Oulu, Oulu, Finland
2Institute of Reproductive and Developmental Biology, Imperial College London, London, UK
3Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
4Unit of General Practice, Oulu University Hospital, Oulu, Finland
5Department of Clinical Chemistry, NordLab Oulu, Oulu University Hospital, University of Oulu, Oulu, Finland
6Department of Children, Young People and Families, National Institute for Health and Welfare, Oulu, Finland
7Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPA) Center for Environment and Health, School of Public Health, Imperial College London, London, UK
8Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2020101584129
Language: English
Published: John Wiley & Sons, 2020
Publish Date: 2021-04-25
Description:

Abstract

Introduction: The aim of the study was to determine the association of body mass index (BMI), self‐reported symptoms or diagnosis of polycystic ovary syndrome (PCOS), and hyperandrogenemia with the occurrence of gestational diabetes mellitus (GDM) through reproductive life.

Material and methods: A cohort of women born in 1966 were investigated at ages 14, 31 and 46. Women with self‐reported PCOS symptoms (presence of both oligo‐amenorrhea and hirsutism) at age 31 or with formally diagnosed polycystic ovaries (PCO)/PCOS by age 46 formed the group of self‐reported PCOS (srPCOS, n = 222) and were compared with women without self‐reported PCOS symptoms or diagnosis (n = 1357). We investigated also the association of hyperandrogenism (hirsutism or biochemical hyperandrogenism) at age 31 with the occurrence of GDM throughout reproductive life.

Results: Self‐reported PCOS alone was not a risk factor for GDM, but combined with overweight at age 31 (odds ratio [OR] 2.43, 95% confidence interval [CI] 1.22‐4.86) or 46 (OR 3.04, 95% CI 1.58‐5.83) srPCOS was associated with GDM when compared with normal weight controls. The association disappeared when comparing overweight srPCOS women with overweight controls. However, hyperandrogenemia at age 31, but not hirsutism, was associated with GDM even after adjustment for BMI.

Conclusions: The increased risk of GDM in women with srPCOS was mostly attributed to overweight or obesity. Importantly, normal weight women with srPCOS did not seem to be at increased risk for developing GDM. However, hyperandrogenemia was associated with GDM even after adjustment for BMI. These findings strengthen the importance of weight management in reproductive‐age women and suggest a noteworthy role of hyperandrogenemia in the pathophysiology of GDM.

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Series: Acta obstetricia et gynecologica Scandinavica
ISSN: 0001-6349
ISSN-E: 1600-0412
ISSN-L: 0001-6349
Volume: 99
Issue: 10
Pages: 1311 - 1319
DOI: 10.1111/aogs.13883
OADOI: https://oadoi.org/10.1111/aogs.13883
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Subjects:
Funding: University Hospital Oulu; Sigrid Juselius Foundation; Wellcome Trust. Grant Number: 089549/Z/09/Z; National Institute for Health Research; Biocenter, University of Oulu. Grant Number: 75617; Finnish Medical Society Duodecim; North Ostrobothnia Regional Fund; Academy of Finland. Grant Numbers: 104781, 120315, 129269, 1114194, 295760; European Commission. Grant Number: QLG1‐CT‐2000‐01643; Medical Research Council. Grant Number: G0802782; Imperial College Healthcare NHS Trust; Imperial College London.
Academy of Finland Grant Number: 129269
Detailed Information: 129269 (Academy of Finland Funding decision)
Copyright information: © 2020 Nordic Federation of Societies of Obstetrics and Gynecology. This is the peer reviewed version of the following article: West, S, Ollila, M‐M, Franks, S, et al. Overweight, obesity and hyperandrogenemia are associated with gestational diabetes mellitus: A follow‐up cohort study. Acta Obstet Gynecol Scand. 2020; 99: 1311– 1319, which has been published in final form at https://doi.org/10.1111/aogs.13883. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.