Women of Korean, Chinese, and Filipino descent are more than twice as likely to develop gestational diabetes as white or African American women, according to a data analysis of more than 16,000 pregnant women in Hawaii published in the December issue of the Ethnicity and Disease journal.

Gestational diabetes occurs in 4%-8% of all pregnant women, wrote Kathryn L. Pedula and her colleagues. Data from a pair of recent U.S. studies suggested that Asians have a higher prevalence of gestational diabetes mellitus (GDM) than do other ethnicities, but differences among subcategories of Asian populations have not been well studied.

Ms. Pedula and her associates at the Center for Health Research, Kaiser Permanente Northwest in Portland, Oregon, reviewed 10 years’ worth of data from 22,110 pregnancies in 16,757 women. Hawaii was chosen for the study because of its ethnically diverse population, the researchers said (Ethn. Dis. 2009;19:414-9).

A total of 353 women had pre-existing diabetes. The remaining women underwent screening for GDM between 24 and 28 weeks of pregnancy, using the 50-gram, 1-hour glucose challenge test (GCT). Women with plasma glucose levels greater than 200 mg/dL on the GCT were deemed to have GDM and were not tested further. The remaining women with a GCT value greater than 140 mg/dL underwent the 100-gram, 3-hour oral glucose tolerance test.

Overall, 20.9% of the women had a positive GCT (plasma glucose at least 140 mg/dL). Approximately 4% had GDM based on the National Diabetes Data Group (NDDG) criteria, and 7% had GDM based on the Carpenter and Coustan (C&C) criteria.

After adjusting for age, the investigators found that 10% of the Korean women had GDM based on the C&C criteria, followed by 9.8% of Chinese women and 8.3% among Filipino women. The prevalence was lowest among African Americans (3.3%) and whites (4.2%).

Based on the NDDG criteria, Puerto Rican women had the highest age-adjusted prevalence of GDM (7.4%), but this was barely higher than the average when C&C criteria were applied. However, Korean, Filipino, and Chinese women had the next highest prevalences of GDM, at 6.4%, 5.8%, and 5.6%, respectively, based on the NDDG criteria. Again, whites and African Americans had the lowest prevalence of GDM, at 2.5% and 2.2%, respectively.

The study included women aged 13-39 years who gave birth in Hawaii between 1995 and 2003. The Asian population was divided into five subgroups: Korean, Chinese, Japanese, Vietnamese, and Filipino. Additional groups included Samoan, Puerto Rican, Native Hawaiian, white, African American, Native American, other Hispanic, and other Pacific Islander.

The results suggest that the risks for developing GDM may vary greatly depending on specific ethnic background. “These findings point to the need for further research along several avenues, such as maternal-child outcome differences and perhaps ethnic-specific guidelines for GDM diagnosis,” the researchers said.

The study was funded by the American Diabetes Association. Coauthor Dr. Teresa A. Hillier was funded by a 1-year ADA-European Association for the Study of Diabetes Trans-Atlantic Fellowship.

Copyright (c) 2009 Elsevier Global Medical News. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

有韩国、中国和菲律宾血统的妇女患妊娠期糖尿病的风险是白种人或非洲裔美国妇女的两倍多，此研究分析了16,000余名夏威夷妊娠妇女的资料，12月份出版的《种族和疾病》(Ethnicity and Disease)报道。

 

在所有妊娠妇女中，4%~8%患妊娠期糖尿病，Kathryn L. Pedula和她的同事写到。最近，美国有两项研究提示，亚洲人妊娠期糖尿病的患病率高于其他种族，但亚洲人群不同种族之间的差异尚未得到很好的研究。

 

俄勒冈州波特兰市Kaiser Permanente Northwest卫生研究中心的Pedula女士和她的同事回顾了10年间16,757名妇女22,110次妊娠的资料。选择夏威夷作为研究对象是因为该地区人群的种族比较丰富，研究者说 (Ethn. Dis. 2009;19:414-9)。

 

353名妇女有糖尿病史，其余妇女在妊娠24周至28周时进行妊娠期糖尿病筛查，采用50g、1h的葡萄糖耐量试验。在葡萄糖耐量试验中，血浆葡萄糖水平高于200 mg/dl的妇女被认为患有妊娠期糖尿病，不再进行检查。血浆葡萄糖水平高于140 mg/dl的妇女进行100g、3h的口服葡萄糖耐量试验。

 

总的来说，20.9%的妇女葡萄糖耐量试验阳性(血浆葡萄糖至少为140 mg/dl)。根据美国国家糖尿病资料组(NDDG)的诊断标准，大约4%的妇女患有妊娠期糖尿病，根据Carpenter和Coustan (C&C)的标准，7%患有妊娠期糖尿病。

 

对年龄进行校准之后，研究者发现，根据C&C标准，10%的韩国妇女患有妊娠期糖尿病，之后是中国妇女(9.8%)和菲律宾妇女(8.3%)。非洲裔美国人(3.3%)和白种人(4.2%)患病率最低。

 

根据NDDG标准，在年龄校准之后，波多黎各人妊娠期糖尿病的患病率最高(7.4%)，但是这仅仅高于采用C&C标准的平均值。韩国、菲律宾和中国妇女妊娠期糖尿病的患病率次之，分别为6.4%、5.8%和5.6%。白种人和非洲裔美国人妊娠期糖尿病的患病率还是最低，分别为2.5%和2.2%。

 

该研究包括了1995年至2003年在夏威夷生育子女的13~39岁妇女。亚洲人群分为5个亚组：韩国人、中国人、日本人、越南人和菲律宾人。另外的组包括萨摩亚人、波多黎各人、夏威夷原住民、白种人、非洲裔美国人、本土美国人，其他西班牙人和其他太平洋岛居民。

 

该结果提示，不同的种族背景患妊娠期糖尿病的风险有很大差异。“该结果指出了进一步研究的方向，例如孕产妇-新生儿结局的差异，或许需要制定妊娠期糖尿病诊断的种族特异性指南。”研究者说道。

 

该研究由美国糖尿病协会资助。合作者Teresa A. Hillier博士由为期1年的美国糖尿病协会-欧洲协会跨大西洋糖尿病研究奖学金资助。

 

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