Association between cardiac arrhythmia before pregnancy and gestational diabetes: a nationwide population-based study in Korea
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Given the higher prevalence of cardiac arrhythmias in individuals with diabetes, we investigated the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM). This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. After excluding those who did not undergo National Health Screening tests within 1 year prior to pregnancy, those with multifetal pregnancies, and those diagnosed with diabetes, we analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy, and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension. Therefore, cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
Abstract
Given the higher prevalence of cardiac arrhythmias in individuals with diabetes, we investigated the relationship between cardiac arrhythmias and the incidence of gestational diabetes (GDM). This retrospective cohort study utilized data from the Korean Health Insurance Service database, encompassing 1,113,729 women who gave birth between January 2007 and December 2015. After excluding those who did not undergo National Health Screening tests within 1 year prior to pregnancy, those with multifetal pregnancies, and those diagnosed with diabetes, we analyzed 365,880 singleton pregnancies without a history of diabetes. Of these, 3,253 (0.9%) had cardiac arrhythmias, including premature extra beats, supraventricular tachyarrhythmias, and/or atrial flutter/fibrillation. GDM occurred in 31,938 (8.7%) subjects during pregnancy, and was more prevalent in women with cardiac arrhythmia than in those without (14.9 vs. 8.7%, p<0.001). In the multivariate analysis, the association between cardiac arrhythmia and GDM remained statistically significant (adjusted odds ratio, 1.78; 95% confidence interval, 1.61 to 1.97; p<0.001). Subgroup analysis revealed that the risk of GDM was consistently statistically significant in subjects with cardiac arrhythmia, regardless of age, body mass index, and the presence or absence of chronic hypertension. Therefore, cardiac arrhythmias before and during pregnancy appear to be associated with an increased risk of developing GDM.
참고문헌 (22)
- American Diabetes Association, "Diagnosis and classification of diabetes mellitus", Diabetes Care, 37(Suppl 1), pp.S81~S90 (2014)
- McIntyre HD, "Gestational diabetes mellitus", Nat Rev Dis Primers, 5, pp.47~ (2019)
- Benhalima K, "Risk factor screening for gestational diabetes mellitus based on the 2013 WHO criteria", Eur J Endocrinol, 180, pp.353~363 (2019)
- Ferrara A, "Increasing prevalence of gestational diabetes mellitus : a public health perspective", Diabetes Care, 30(Suppl 2), pp.S141~S146 (2007)
- Shotan A, "Incidence of arrhythmias in normal pregnancy and relation to palpitations, dizziness, and syncope", Am J Cardiol, 79, pp.1061~1064 (1997)
- Adamson DL, "Managing palpitations and arrhythmias during pregnancy", Heart, 93, pp.1630~1636 (2007)
- Grisanti LA, "Diabetes and arrhythmias : pathophysiology, mechanisms and therapeutic outcomes", Front Physiol, 9, pp.1669~ (2018)
- Park Y, "Increased cardiac arrhythmia after pregnancy-induced hypertension : a South Korean Nationwide Database Study", J Am Heart Assoc, 11, pp.e023013~ (2022)
- Massing MW, "Usefulness of ventricular premature complexes to predict coronary heart disease events and mortality(from the Atherosclerosis Risk In Communities cohort)", Am J Cardiol, 98, pp.1609~1612 (2006)
- Lee V, "The prognostic significance of premature ventricular complexes in adults without clinically apparent heart disease : a meta-analysis and systematic review", Heart, 98, pp.1290~1298 (2012)
- Askin L, "Ambulatory blood pressure results and heart rate variability in patients with premature ventricular contractions", Clin Exp Hypertens, 40, pp.251~256 (2018)
- von Rotz M, "Risk factors for premature ventricular contractions in young and healthy adults", Heart, 103, pp.702~707 (2017)
- Guilleminault C, "Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome", Am J Cardiol, 52, pp.490~494 (1983)
- Chen Y, "Higher high-sensitivity C reactive protein is associated with future premature ventricular contraction : a community based prospective cohort study", Sci Rep, 8, pp.5152~ (2018)
- Wu H, "Psychological factors and risk of atrial fibrillation : a meta-analysis and systematic review", Int J Cardiol, 362, pp.85~92 (2022)
- Brunner S, "Alcohol consumption, sinus tachycardia, and cardiac arrhythmias at the Munich Octoberfest : results from the Munich Beer Related Electrocardiogram Workup Study(MunichBREW)", Eur Heart J, 38, pp.2100~2106 (2017)
- De Sensi F, "Atrial fibrillation in patients with diabetes : molecular mechanisms and therapeutic perspectives", Cardiovasc Diagn Ther, 5, pp.364~373 (2015)
- Coumel P, "Cardiac arrhythmias and the autonomic nervous system", J Cardiovasc Electrophysiol, 4, pp.338~355 (1993)
- Perciaccante A, "Circadian rhythm of the autonomic nervous system in insulin resistant subjects with normoglycemia, impaired fasting glycemia, impaired glucose tolerance, type 2 diabetes mellitus", BMC Cardiovasc Disord, 6, pp.19~ (2006)
- Duncan DJ, "TNF-alpha and IL-1beta increase Ca2+ leak from the sarcoplasmic reticulum and susceptibility to arrhythmia in rat ventricular myocytes", Cell Calcium, 47, pp.378~386 (2010)
- Lekva T, "Impact of systemic inflammation on the progression of gestational diabetes mellitus", Curr Diab Rep, 16, pp.26~ (2016)
- Pitsavos C, "Association between low-grade systemic inflammation and type 2 diabetes mellitus among men and women from the ATTICA study", Rev Diabet Stud, 4, pp.98~104 (2007)
