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Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis

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Abstract

Many studies assessed the association between hypertensive disorders during pregnancy and risk of type 2 diabetes mellitus in later life, but contradictory findings were reported. A systemic review and meta-analysis was carried out to elucidate type 2 diabetes mellitus risk in women with hypertensive disorders during pregnancy. Pubmed, Embase, and Web of Science were searched for cohort or case-control studies on the association between hypertensive disorders during pregnancy and subsequent type 2 diabetes mellitus. Random-effect model was used to pool risk estimates. Bayesian meta-analysis was carried out to further estimate the type 2 diabetes mellitus risk associated with hypertensive disorders during pregnancy. Seventeen cohort or prospective matched case-control studies were finally included. Those 17 studies involved 2,984,634 women and 46,732 type 2 diabetes mellitus cases. Overall, hypertensive disorders during pregnancy were significantly correlated with type 2 diabetes mellitus risk (relative risk = 1.56, 95 % confidence interval 1.21–2.01, P = 0.001). Preeclampsia was significantly and independently correlated with type 2 diabetes mellitus risk (relative risk = 2.25, 95 % confidence interval 1.73–2.90, P < 0.001). In addition, gestational hypertension was also significantly and independently correlated with subsequent type 2 diabetes mellitus risk (relative risk = 2.06, 95 % confidence interval 1.57–2.69, P < 0.001). The pooled estimates were not significantly altered in the subgroup analyses of studies on preeclampsia or gestational hypertension. Bayesian meta-analysis showed the relative risks of type 2 diabetes mellitus risk for individuals with hypertensive disorders during pregnancy, preeclampsia, and gestational hypertension were 1.59 (95 % credibility interval: 1.11–2.32), 2.27 (95 % credibility interval: 1.67–2.97), and 2.06 (95 % credibility interval: 1.41–2.84), respectively. Publication bias was not evident in the meta-analysis. Preeclampsia and gestational hypertension are independently associated with substantially elevated risk of type 2 diabetes mellitus in later life.

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Acknowledgments

The authors thank Dr. Pingping Wang for her kind help in providing professional advice for our study.

Funding

This study was supported by the Development Program of Science and Technology in Medicine and Health from Shandong Province (No.2015WS0085).

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Authors and Affiliations

  1. Department of Obstetrics, Maternal and Children Health’s Hospital of Weifang, Weifang, 261011, China

    Zengfang Wang

  2. Surgical Center, Zhucheng People’s Hospital, Zhucheng, 262201, China

    Zengyan Wang

  3. Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China

    Luang Wang, Mingyue Qiu, Yangang Wang, Xu Hou & Bin Wang

  4. Department of Medical Education, Health School of Ganzhou in Jiangxi Province, Ganzhou, 341000, China

    Zhong Guo

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Wang, Z., Wang, Z., Wang, L. et al. Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis. Endocrine 55, 809–821 (2017). https://doi.org/10.1007/s12020-016-1075-6

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