AimTo investigate the association of gestational diabetes mellitus (GDM) with premature mortality and cardiovascular (CVD) outcomes and risk factors.Materials and MethodsParous women recruited to the UK Biobank cohort during 2006‐2010 were followed up from their first delivery until 31 October 2021. The data were linked to Hospital Episode Statistics and mortality registries. Multivariate Cox proportional hazard models investigated associations of GDM with all‐cause mortality, CVD, diabetes, hypertension and dyslipidaemia.ResultsThe maximum total analysis time at risk and under observation was 9 694 090 person‐years. Among 220 726 women, 1225 self‐reported or had a recorded diagnosis of GDM. After adjusting for confounders and behavioural factors, GDM was associated with increased risk for premature mortality [hazard ratio (HR): 1.44, 95% confidence interval (CI): 1.12‐1.86], particularly CVD‐related death (HR: 2.38, 95% CI: 1.63‐3.48), as well as incident total CVD (HR: 1.50, 95% CI: 1.30‐1.74), non‐fatal CVD (HR: 1.41, 95% CI: 1.20‐1.65), diabetes (HR: 14.37, 95% CI: 13.51‐15.27), hypertension (HR: 1.49, 95% CI: 1.38‐1.60), and dyslipidaemia (HR: 1.30, 95% CI: 1.22‐1.39). The total CVD risk was greater in women with GDM who did not later develop diabetes than in those with GDM and diabetes.ConclusionsWomen with GDM are at increased risk of premature death and have increased CV risk, emphasizing the importance of interventions to prevent GDM. If GDM develops, the diagnosis represents an opportunity for future surveillance and intervention to reduce CVD risk factors, prevent CVD and improve long‐term health.

中文翻译：

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妊娠糖尿病与过早死亡的长期风险以及心血管结局和危险因素的关联：英国生物银行的回顾性队列分析

目的 调查妊娠期糖尿病 (GDM) 与过早死亡和心血管 (CVD) 结局及危险因素的关系。 材料和方法 对 2006 年至 2010 年期间招募到英国生物银行队列的已产妇女进行随访，从首次分娩到 2021 年 10 月 31 日。这些数据与医院发病统计和死亡率登记相关。多变量 Cox 比例风险模型研究了 GDM 与全因死亡率、CVD、糖尿病、高血压和血脂异常的关联。结果风险和观察中的最大总分析时间为 9 694 090 人年。在 220 726 名女性中，有 1225 名自我报告或记录诊断为 GDM。调整混杂因素和行为因素后，GDM 与过早死亡风险增加相关[风险比 (HR)：1.44，95% 置信区间 (CI)：1.12‐1.86]，特别是 CVD 相关死亡（HR：2.38，95） % CI：1.63-3.48），以及总 CVD 事件（HR：1.50，95% CI：1.30-1.74）、非致命 CVD（HR：1.41，95% CI：1.20-1.65）、糖尿病（HR： 14.37，95% CI：13.51-15.27）、高血压（HR：1.49，95% CI：1.38-1.60）和血脂异常（HR：1.30，95% CI：1.22-1.39）。与 GDM 合并糖尿病的女性相比，后来未患糖尿病的 GDM 女性的总 CVD 风险更高。结论 GDM 女性过早死亡的风险增加，心血管风险也增加，强调了预防 GDM 干预措施的重要性。如果发生 GDM，诊断将为未来进行监测和干预提供机会，以减少 CVD 危险因素、预防 CVD 并改善长期健康。