Matias Vaajala, Ilari Kuitunen, Rasmus Liukkonen, Ville Ponkilainen, Maiju Kekki, Ville M. Mattila
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Women who had sustained previous fractures of the upper extremity, pelvis, or lower extremity were included in the control group. A logistic regression model was used to assess the risk for the development of GDM during pregnancy. Adjusted odds ratios (aOR) with 95% confidence intervals between the groups were compared. The model was adjusted by prepregnancy body mass index (BMI) and maternal age during pregnancy, the use of in vitro fertilization (IVF), maternal smoking status, and multiple pregnancies. The risk for the development of GDM during different periods following the injury (0–3 years, 3–6 years, 6–9 years, and 9+ years) was calculated.</p><h3>Results</h3><p>In total, a 75 g 2-h oral glucose tolerance test (OGTT) was performed on 6802 pregnancies of women who had sustained a TBI and on 11 717 pregnancies of women who sustained fractures of the upper extremity, pelvis, or lower extremity. Of these, 1889 (27.8%) pregnancies were diagnosed with GDM in the patient group and 3117 (26.6%) in the control group. The total odds for GDM were higher after TBI compared to the other traumas (aOR 1.14, CI 1.06–1.22). The odds were highest at 9 + years after the injury (aOR 1.22, CI 1.07–1.39).</p><h3>Conclusion</h3><p>The total odds for the development of GDM after TBI were higher when compared to the control group. Based on our findings, more research on this topic is warranted. Moreover, a history of TBI should be considered a possible risk factor for the development of GDM.</p></div>","PeriodicalId":6921,"journal":{"name":"Acta Diabetologica","volume":"60 10","pages":"1399 - 1404"},"PeriodicalIF":3.1000,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://link.springer.com/content/pdf/10.1007/s00592-023-02129-5.pdf","citationCount":"0","resultStr":"{\"title\":\"Previous traumatic brain injury is associated with an increased odds for gestational diabetes: a nationwide register-based cohort study in finland\",\"authors\":\"Matias Vaajala, Ilari Kuitunen, Rasmus Liukkonen, Ville Ponkilainen, Maiju Kekki, Ville M. Mattila\",\"doi\":\"10.1007/s00592-023-02129-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>Despite recent findings that traumatic brain injury (TBI) is a possible risk factor for type 2 diabetes (DM2) and that a strong association exists between gestational diabetes (GDM) and the risk for the development of DM2, no previous studies have investigated the effects of TBI on the risk for the development of GDM. Therefore, this study aims to determine the possible association between a previous traumatic brain injury and later gestational diabetes.</p><h3>Methods</h3><p>In this retrospective register-based cohort study, data from the National Medical Birth Register were combined with data from the Care Register for Health Care. Women who had sustained a TBI before pregnancy were included in the patient group. Women who had sustained previous fractures of the upper extremity, pelvis, or lower extremity were included in the control group. A logistic regression model was used to assess the risk for the development of GDM during pregnancy. Adjusted odds ratios (aOR) with 95% confidence intervals between the groups were compared. The model was adjusted by prepregnancy body mass index (BMI) and maternal age during pregnancy, the use of in vitro fertilization (IVF), maternal smoking status, and multiple pregnancies. The risk for the development of GDM during different periods following the injury (0–3 years, 3–6 years, 6–9 years, and 9+ years) was calculated.</p><h3>Results</h3><p>In total, a 75 g 2-h oral glucose tolerance test (OGTT) was performed on 6802 pregnancies of women who had sustained a TBI and on 11 717 pregnancies of women who sustained fractures of the upper extremity, pelvis, or lower extremity. Of these, 1889 (27.8%) pregnancies were diagnosed with GDM in the patient group and 3117 (26.6%) in the control group. 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引用次数: 0
摘要
目的尽管最近发现创伤性脑损伤（TBI）可能是2型糖尿病（DM2）的危险因素，并且妊娠期糖尿病（GDM）与发展为DM2的风险之间存在强烈的相关性，但以前没有研究过TBI对发展为GDM的风险的影响。因此，本研究旨在确定既往创伤性脑损伤与妊娠后期糖尿病之间的可能联系。方法在这项基于登记的回顾性队列研究中，将来自国家医疗出生登记的数据与来自医疗保健登记的数据相结合。患者组中包括在怀孕前患有创伤性脑损伤的女性。曾遭受上肢、骨盆或下肢骨折的女性被纳入对照组。采用逻辑回归模型评估妊娠期GDM发生的风险。比较两组之间95%置信区间的调整比值比（aOR）。该模型通过孕前体重指数（BMI）和妊娠期间的母亲年龄、体外受精（IVF）的使用、母亲吸烟状况和多胎妊娠进行了调整。计算受伤后不同时期（0-3年、3-6年、6-9年和9+年）发生GDM的风险。结果总共对6802名患有TBI的孕妇和11717名患有上肢、骨盆或下肢骨折的孕妇进行了75 g 2 h口服葡萄糖耐量试验（OGTT）。其中，患者组1889例（27.8%）妊娠被诊断为GDM，对照组3117例（26.6%）。与其他创伤相比，TBI后发生GDM的总几率更高（aOR 1.14，CI 1.06-1.22）。几率最高为9 + 结论与对照组相比，TBI后发生GDM的总几率更高。根据我们的发现，有必要对这一主题进行更多的研究。此外，TBI病史应被视为GDM发展的可能风险因素。
Previous traumatic brain injury is associated with an increased odds for gestational diabetes: a nationwide register-based cohort study in finland
Aims
Despite recent findings that traumatic brain injury (TBI) is a possible risk factor for type 2 diabetes (DM2) and that a strong association exists between gestational diabetes (GDM) and the risk for the development of DM2, no previous studies have investigated the effects of TBI on the risk for the development of GDM. Therefore, this study aims to determine the possible association between a previous traumatic brain injury and later gestational diabetes.
Methods
In this retrospective register-based cohort study, data from the National Medical Birth Register were combined with data from the Care Register for Health Care. Women who had sustained a TBI before pregnancy were included in the patient group. Women who had sustained previous fractures of the upper extremity, pelvis, or lower extremity were included in the control group. A logistic regression model was used to assess the risk for the development of GDM during pregnancy. Adjusted odds ratios (aOR) with 95% confidence intervals between the groups were compared. The model was adjusted by prepregnancy body mass index (BMI) and maternal age during pregnancy, the use of in vitro fertilization (IVF), maternal smoking status, and multiple pregnancies. The risk for the development of GDM during different periods following the injury (0–3 years, 3–6 years, 6–9 years, and 9+ years) was calculated.
Results
In total, a 75 g 2-h oral glucose tolerance test (OGTT) was performed on 6802 pregnancies of women who had sustained a TBI and on 11 717 pregnancies of women who sustained fractures of the upper extremity, pelvis, or lower extremity. Of these, 1889 (27.8%) pregnancies were diagnosed with GDM in the patient group and 3117 (26.6%) in the control group. The total odds for GDM were higher after TBI compared to the other traumas (aOR 1.14, CI 1.06–1.22). The odds were highest at 9 + years after the injury (aOR 1.22, CI 1.07–1.39).
Conclusion
The total odds for the development of GDM after TBI were higher when compared to the control group. Based on our findings, more research on this topic is warranted. Moreover, a history of TBI should be considered a possible risk factor for the development of GDM.
期刊介绍：
Acta Diabetologica is a journal that publishes reports of experimental and clinical research on diabetes mellitus and related metabolic diseases. Original contributions on biochemical, physiological, pathophysiological and clinical aspects of research on diabetes and metabolic diseases are welcome. Reports are published in the form of original articles, short communications and letters to the editor. Invited reviews and editorials are also published. A Methodology forum, which publishes contributions on methodological aspects of diabetes in vivo and in vitro, is also available. The Editor-in-chief will be pleased to consider articles describing new techniques (e.g., new transplantation methods, metabolic models), of innovative importance in the field of diabetes/metabolism. Finally, workshop reports are also welcome in Acta Diabetologica.
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