title: Early possible risk factors for overt diabetes after gestational diabetes mellitus.
abstract: OBJECTIVE
  To assess a cluster of risk factors, including parameters of the metabolic syndrome, in women with gestational diabetes mellitus (GDM) early after delivery, that features the best prediction for developing diabetes.
  
  
  METHODS
  Women with GDM 3-6 months after delivery received a complete metabolic characterization at baseline as well as annually for up to 10 years of follow-up (N=110). We used parameters characterizing the metabolic syndrome as well as demographic variables at baseline to predict diabetes manifestation.
  
  
  RESULTS
  Metabolic disturbances and insulin treatment during pregnancy were significantly associated with overt diabetes. Waist circumference of 80 cm or higher failed to show a significant effect on later development of the disease; however, it was significant when 88 cm or more was used as a cutoff value. We identified impaired glucose tolerance (13 [56.5%]; hazard ratio 6.77, confidence interval [CI] 2.96-15.45, P<.001) as well as high-density lipoprotein (HDL) cholesterol less than 50 mg/dL (14 [60.9%]; hazard ratio 2.88, CI 1.24-6.67, P=.010) and age older than 35 years (12 [52.2%]; hazard ratio 3.06, CI 1.32-7.12, P=.006) as the best predictors with additive effects. Women with at least two risk factors had a higher risk to develop the disease as compared with those women who showed only one risk factor (hazard ratio 3.2, CI 1.4-7.7, P=.008).
  
  
  CONCLUSIONS
  Impaired glucose tolerance, HDL cholesterol less than 50 mg/dL, and age older than 35 years were identified as the best predictors of developing diabetes after GDM.
authors.affiliation: From the Department of Internal Medicine III, Division of Endocrinology and Metabolism, Unit of Gender Medicine, the Department of Gynecology and Obstetrics, and the Department of Internal Medicine III, Division of Nephrology, Medical University of Vienna, Vienna, Austria; and the Metabolic Unit, Institute of Biomedical Engineering, National Research Council, Padova, Italy.
authors.forename: Christian S
authors.initials: CS
authors.lastname: Göbl
authors.forename: Latife
authors.initials: L
authors.lastname: Bozkurt
authors.forename: Thomas
authors.initials: T
authors.lastname: Prikoszovich
authors.forename: Christine
authors.initials: C
authors.lastname: Winzer
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pacini
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
mesh_terms: D008076:Cholesterol, HDL / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology; D015999:Multivariate Analysis; D011247:Pregnancy; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D008076:Cholesterol, HDL