Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study
Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions. Prospective c...
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| Veröffentlicht in: | American journal of kidney diseases 2018-01, Vol.71 (1), p.112-122 |
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| creator | Dehmer, Elizabeth W. Phadnis, Milind A. Gunderson, Erica P. Lewis, Cora E. Bibbins-Domingo, Kirsten Engel, Stephanie M. Jonsson Funk, Michele Kramer, Holly Kshirsagar, Abhijit V. Heiss, Gerardo |
| description | Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions.
Prospective cohort.
Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks’ gestation, and had kidney function measurements during 25 years of follow-up.
GDM was self-reported by women for each pregnancy.
CKD was defined as the development of estimated glomerular filtration rate (eGFR) |
| doi_str_mv | 10.1053/j.ajkd.2017.08.015 |
| format | Article |
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Prospective cohort.
Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks’ gestation, and had kidney function measurements during 25 years of follow-up.
GDM was self-reported by women for each pregnancy.
CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25.
HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM.
During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83).
Albuminuria was assessed by single untimed measurements of urine albumin and creatinine.
GDM is associated with the subsequent development of albuminuria among black women in CARDIA.</description><identifier>ISSN: 0272-6386</identifier><identifier>EISSN: 1523-6838</identifier><identifier>DOI: 10.1053/j.ajkd.2017.08.015</identifier><identifier>PMID: 29128412</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; African American ; albuminuria ; Albuminuria - diagnosis ; Albuminuria - ethnology ; Albuminuria - etiology ; Black or African American - statistics & numerical data ; Body Mass Index ; chronic kidney disease (CKD) ; CKD risk factor ; Cohort Studies ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - epidemiology ; Creatinine - blood ; diabetes mellitus ; Diabetes, Gestational - diagnosis ; Diabetes, Gestational - epidemiology ; Female ; Gestational diabetes mellitus (GDM) ; Humans ; Incidence ; incident CKD ; Kidney Function Tests - methods ; Pregnancy ; Prospective Studies ; race/ethnicity ; Renal Insufficiency, Chronic - diagnosis ; Renal Insufficiency, Chronic - epidemiology ; Risk Factors ; United States - epidemiology ; White People - statistics & numerical data ; Young Adult</subject><ispartof>American journal of kidney diseases, 2018-01, Vol.71 (1), p.112-122</ispartof><rights>2017 National Kidney Foundation, Inc.</rights><rights>Copyright © 2017 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-26e37715ae10a3249530a0b44c4e785dc94640843474ff34a4177cd744a760413</citedby><cites>FETCH-LOGICAL-c455t-26e37715ae10a3249530a0b44c4e785dc94640843474ff34a4177cd744a760413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.ajkd.2017.08.015$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,778,782,883,3539,27907,27908,45978</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29128412$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dehmer, Elizabeth W.</creatorcontrib><creatorcontrib>Phadnis, Milind A.</creatorcontrib><creatorcontrib>Gunderson, Erica P.</creatorcontrib><creatorcontrib>Lewis, Cora E.</creatorcontrib><creatorcontrib>Bibbins-Domingo, Kirsten</creatorcontrib><creatorcontrib>Engel, Stephanie M.</creatorcontrib><creatorcontrib>Jonsson Funk, Michele</creatorcontrib><creatorcontrib>Kramer, Holly</creatorcontrib><creatorcontrib>Kshirsagar, Abhijit V.</creatorcontrib><creatorcontrib>Heiss, Gerardo</creatorcontrib><title>Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study</title><title>American journal of kidney diseases</title><addtitle>Am J Kidney Dis</addtitle><description>Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions.
Prospective cohort.
Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks’ gestation, and had kidney function measurements during 25 years of follow-up.
GDM was self-reported by women for each pregnancy.
CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25.
HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM.
During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83).
Albuminuria was assessed by single untimed measurements of urine albumin and creatinine.
GDM is associated with the subsequent development of albuminuria among black women in CARDIA.</description><subject>Adult</subject><subject>African American</subject><subject>albuminuria</subject><subject>Albuminuria - diagnosis</subject><subject>Albuminuria - ethnology</subject><subject>Albuminuria - etiology</subject><subject>Black or African American - statistics & numerical data</subject><subject>Body Mass Index</subject><subject>chronic kidney disease (CKD)</subject><subject>CKD risk factor</subject><subject>Cohort Studies</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Creatinine - blood</subject><subject>diabetes mellitus</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>Female</subject><subject>Gestational diabetes mellitus (GDM)</subject><subject>Humans</subject><subject>Incidence</subject><subject>incident CKD</subject><subject>Kidney Function Tests - methods</subject><subject>Pregnancy</subject><subject>Prospective Studies</subject><subject>race/ethnicity</subject><subject>Renal Insufficiency, Chronic - diagnosis</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Risk Factors</subject><subject>United States - epidemiology</subject><subject>White People - statistics & numerical data</subject><subject>Young Adult</subject><issn>0272-6386</issn><issn>1523-6838</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9Uctu1DAUjRCIDoUfYIG8LIsEv2InCFUKmVJGFCGVsmBleZw7racZe7CTqeYL-G0cplSwYXWlex736J4se0lwQXDJ3qwLvb7tCoqJLHBVYFI-ymakpCwXFaseZzNMJc0Fq8RR9izGNca4ZkI8zY5oTWjFCZ1lP5sYvbF6sN6h9zDcATh0DnH4vdE9mlu9hAEi0q5DC2dsB25An_UAYYLbT_O36OoGUOtD4oc9akKC9ujSxls0hx30fruZJNah735016jpxn6I6KRtLueL5jX6Oozd_nn2ZKX7CC_u53H27cPZVfsxv_hyvmibi9zwshxyKoBJSUoNBGtGeV0yrPGSc8NBVmVnai44rjjjkq9WjGtOpDSd5FxLgTlhx9npwXc7LjfQmZQs6F5tg92k8Mprq_5FnL1R136nSskpriaDk3uD4H-M6VFqY6OBvtcO_BgVqQXjggghE5UeqCb4GAOsHs4QrKYG1VpNDaqpQYUrlRpMold_B3yQ_KksEd4dCJDetLMQVDQWnIHOBjCD6rz9n_8v-Zisow</recordid><startdate>20180101</startdate><enddate>20180101</enddate><creator>Dehmer, Elizabeth W.</creator><creator>Phadnis, Milind A.</creator><creator>Gunderson, Erica P.</creator><creator>Lewis, Cora E.</creator><creator>Bibbins-Domingo, Kirsten</creator><creator>Engel, Stephanie M.</creator><creator>Jonsson Funk, Michele</creator><creator>Kramer, Holly</creator><creator>Kshirsagar, Abhijit V.</creator><creator>Heiss, Gerardo</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20180101</creationdate><title>Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study</title><author>Dehmer, Elizabeth W. ; Phadnis, Milind A. ; Gunderson, Erica P. ; Lewis, Cora E. ; Bibbins-Domingo, Kirsten ; Engel, Stephanie M. ; Jonsson Funk, Michele ; Kramer, Holly ; Kshirsagar, Abhijit V. ; Heiss, Gerardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-26e37715ae10a3249530a0b44c4e785dc94640843474ff34a4177cd744a760413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>African American</topic><topic>albuminuria</topic><topic>Albuminuria - diagnosis</topic><topic>Albuminuria - ethnology</topic><topic>Albuminuria - etiology</topic><topic>Black or African American - statistics & numerical data</topic><topic>Body Mass Index</topic><topic>chronic kidney disease (CKD)</topic><topic>CKD risk factor</topic><topic>Cohort Studies</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Creatinine - blood</topic><topic>diabetes mellitus</topic><topic>Diabetes, Gestational - diagnosis</topic><topic>Diabetes, Gestational - epidemiology</topic><topic>Female</topic><topic>Gestational diabetes mellitus (GDM)</topic><topic>Humans</topic><topic>Incidence</topic><topic>incident CKD</topic><topic>Kidney Function Tests - methods</topic><topic>Pregnancy</topic><topic>Prospective Studies</topic><topic>race/ethnicity</topic><topic>Renal Insufficiency, Chronic - diagnosis</topic><topic>Renal Insufficiency, Chronic - epidemiology</topic><topic>Risk Factors</topic><topic>United States - epidemiology</topic><topic>White People - statistics & numerical data</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dehmer, Elizabeth W.</creatorcontrib><creatorcontrib>Phadnis, Milind A.</creatorcontrib><creatorcontrib>Gunderson, Erica P.</creatorcontrib><creatorcontrib>Lewis, Cora E.</creatorcontrib><creatorcontrib>Bibbins-Domingo, Kirsten</creatorcontrib><creatorcontrib>Engel, Stephanie M.</creatorcontrib><creatorcontrib>Jonsson Funk, Michele</creatorcontrib><creatorcontrib>Kramer, Holly</creatorcontrib><creatorcontrib>Kshirsagar, Abhijit V.</creatorcontrib><creatorcontrib>Heiss, Gerardo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of kidney diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dehmer, Elizabeth W.</au><au>Phadnis, Milind A.</au><au>Gunderson, Erica P.</au><au>Lewis, Cora E.</au><au>Bibbins-Domingo, Kirsten</au><au>Engel, Stephanie M.</au><au>Jonsson Funk, Michele</au><au>Kramer, Holly</au><au>Kshirsagar, Abhijit V.</au><au>Heiss, Gerardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study</atitle><jtitle>American journal of kidney diseases</jtitle><addtitle>Am J Kidney Dis</addtitle><date>2018-01-01</date><risdate>2018</risdate><volume>71</volume><issue>1</issue><spage>112</spage><epage>122</epage><pages>112-122</pages><issn>0272-6386</issn><eissn>1523-6838</eissn><abstract>Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions.
Prospective cohort.
Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks’ gestation, and had kidney function measurements during 25 years of follow-up.
GDM was self-reported by women for each pregnancy.
CKD was defined as the development of estimated glomerular filtration rate (eGFR)<60mL/min/1.73m2 or urine albumin-creatinine ratio ≥ 25mg/g at any one CARDIA examination in years 10, 15, 20, or 25.
HRs for developing CKD were estimated for women who developed GDM versus women without GDM using complementary log-log models, adjusting for prepregnancy age, systolic blood pressure, dyslipidemia, body mass index, smoking, education, eGFR, fasting glucose concentration, physical activity level (all measured at the CARDIA examination before the first pregnancy), race, and family history of diabetes. We explored for an interaction between race and GDM.
During a mean follow-up of 20.8 years, 105 of 820 (12.8%) women developed CKD, predominantly increased urine albumin excretion (98 albuminuria only, 4 decreased eGFR only, and 3 both). There was evidence of a GDM-race interaction on CKD risk (P=0.06). Among black women, the adjusted HR for CKD was 1.96 (95% CI, 1.04-3.67) in GDM compared with those without GDM. Among white women, the HR was 0.65 (95% CI, 0.23-1.83).
Albuminuria was assessed by single untimed measurements of urine albumin and creatinine.
GDM is associated with the subsequent development of albuminuria among black women in CARDIA.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29128412</pmid><doi>10.1053/j.ajkd.2017.08.015</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 0272-6386 |
| ispartof | American journal of kidney diseases, 2018-01, Vol.71 (1), p.112-122 |
| issn | 0272-6386 1523-6838 |
| language | eng |
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| source | Elsevier ScienceDirect Journals Complete - AutoHoldings; MEDLINE |
| subjects | Adult African American albuminuria Albuminuria - diagnosis Albuminuria - ethnology Albuminuria - etiology Black or African American - statistics & numerical data Body Mass Index chronic kidney disease (CKD) CKD risk factor Cohort Studies Coronary Artery Disease - diagnosis Coronary Artery Disease - epidemiology Creatinine - blood diabetes mellitus Diabetes, Gestational - diagnosis Diabetes, Gestational - epidemiology Female Gestational diabetes mellitus (GDM) Humans Incidence incident CKD Kidney Function Tests - methods Pregnancy Prospective Studies race/ethnicity Renal Insufficiency, Chronic - diagnosis Renal Insufficiency, Chronic - epidemiology Risk Factors United States - epidemiology White People - statistics & numerical data Young Adult |
| title | Association Between Gestational Diabetes and Incident Maternal CKD: The Coronary Artery Risk Development in Young Adults (CARDIA) Study |
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