Group-based developmental BMI trajectories, polycystic ovary syndrome, and gestational diabetes: a community-based longitudinal study

BMC Medicine

Research Article

Lisa J. Moran¹  Nadira Sultana Kakoly¹  Arul Earnest¹  Helena J. Teede²  Anju E. Joham³ 

[1] Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 3168, Clayton, Victoria, Australia;Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 3168, Clayton, Victoria, Australia;Diabetes and Vascular Medicine Unit, Monash Health, 3168, Clayton, Victoria, Australia;Monash Partners Academic Health Sciences Centre, Melbourne, Victoria, Australia;Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, 3168, Clayton, Victoria, Australia;Diabetes and Vascular Medicine Unit, Monash Health, 3168, Clayton, Victoria, Australia;School of Public Health and Preventive Medicine, Monash University, Locked bag 29, Monash Medical Centre, 3168, Clayton, Victoria, Australia;

关键词: Polycystic ovary syndrome;    BMI;    Longitudinal;    Gestational diabetes;    Latent-curve analysis;   

DOI  :  10.1186/s12916-017-0957-7

 received in 2017-06-18, accepted in 2017-10-13,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundObesity is common in young women, increasing insulin resistance (IR) and worsening pregnancy complications, including gestational diabetes (GDM). Women with polycystic ovary syndrome (PCOS) are commonly obese, which aggravates the severity of PCOS clinical expression. Relationships between these common insulin-resistant conditions, however, remain unclear.MethodsWe conducted a secondary analysis of the Australian Longitudinal Study on Women’s Health (ALSWH) database, including data from 8009 women aged 18–36 years across six surveys. We used latent-curve growth modelling to identify distinct body mass index (BMI) trajectories and multinomial logistic regression to explore sociodemographic and health variables characterizing BMI group membership. Logistic regression was used to assess independent risk of GDM.ResultsA total of 662 women (8.29%, 95% CI 7.68–8.89) reported PCOS. Three distinct BMI trajectories emerged, namely low stable (LSG) (63.8%), defined as an average trajectory remaining at ~25 kg/m2; moderately rising (MRG) (28.8%), a curvilinear trajectory commencing in a healthy BMI and terminating in the overweight range; and high-rising (HRG) (7.4%), a curvilinear trajectory starting and terminating in the obese range. A high BMI in early reproductive life predicted membership in higher trajectories. The HRG BMI trajectory was independently associated with GDM (OR 2.50, 95% CI 1.80–3.48) and was a stronger correlate than PCOS (OR 1.89, 95% CI 1.41–2.54), maternal age, socioeconomic status, or parity.ConclusionOur results suggest heterogeneity in BMI change among Australian women of reproductive age, with and without PCOS. Reducing early adult life weight represents an ideal opportunity to intervene at an early stage of reproductive life and decreases the risk of long-term metabolic complications such as GDM.

【 授权许可】

CC BY   
© The Author(s). 2017