nach oben

Endocrine

Erschienen in:

12.08.2016 | Original Article

Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis

verfasst von: Zengfang Wang, Zengyan Wang, Luang Wang, Mingyue Qiu, Yangang Wang, Xu Hou, Zhong Guo, Bin Wang

Erschienen in: Endocrine | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Many studies assessed the association between hypertensive disorders during pregnancy and risk of type 2 diabetes mellitus in later life, but contradictory findings were reported. A systemic review and meta-analysis was carried out to elucidate type 2 diabetes mellitus risk in women with hypertensive disorders during pregnancy. Pubmed, Embase, and Web of Science were searched for cohort or case-control studies on the association between hypertensive disorders during pregnancy and subsequent type 2 diabetes mellitus. Random-effect model was used to pool risk estimates. Bayesian meta-analysis was carried out to further estimate the type 2 diabetes mellitus risk associated with hypertensive disorders during pregnancy. Seventeen cohort or prospective matched case-control studies were finally included. Those 17 studies involved 2,984,634 women and 46,732 type 2 diabetes mellitus cases. Overall, hypertensive disorders during pregnancy were significantly correlated with type 2 diabetes mellitus risk (relative risk = 1.56, 95 % confidence interval 1.21–2.01, P = 0.001). Preeclampsia was significantly and independently correlated with type 2 diabetes mellitus risk (relative risk = 2.25, 95 % confidence interval 1.73–2.90, P < 0.001). In addition, gestational hypertension was also significantly and independently correlated with subsequent type 2 diabetes mellitus risk (relative risk = 2.06, 95 % confidence interval 1.57–2.69, P < 0.001). The pooled estimates were not significantly altered in the subgroup analyses of studies on preeclampsia or gestational hypertension. Bayesian meta-analysis showed the relative risks of type 2 diabetes mellitus risk for individuals with hypertensive disorders during pregnancy, preeclampsia, and gestational hypertension were 1.59 (95 % credibility interval: 1.11–2.32), 2.27 (95 % credibility interval: 1.67–2.97), and 2.06 (95 % credibility interval: 1.41–2.84), respectively. Publication bias was not evident in the meta-analysis. Preeclampsia and gestational hypertension are independently associated with substantially elevated risk of type 2 diabetes mellitus in later life.

Nur mit Berechtigung zugänglich

C. Visintin, M.A. Mugglestone, M.Q. Almerie, L.M. Nherera, D. James, S. Walkinshaw, Management of hypertensive disorders during pregnancy: summary of NICE guidance. BMJ 341, c2207 (2010). doi:10.1136/bmj.c2207 CrossRefPubMed

E.A. Steegers, P. von Dadelszen, J.J. Duvekot, R. Pijnenborg, Pre-eclampsia. Lancet 376(9741), 631–644 (2010). doi:10.1016/S0140-6736(10)60279-6 CrossRefPubMed

R.L. Goldenberg, J.F. Culhane, J.D. Iams, R. Romero, Epidemiology and causes of preterm birth. Lancet 371(9606), 75–84 (2008). doi:10.1016/S0140-6736(08)60074-4 CrossRefPubMed

J.O. Lo, J.F. Mission, A.B. Caughey, Hypertensive disease of pregnancy and maternal mortality. Curr. Opin. Obstet. Gynecol. 25(2), 124–132 (2013). doi:10.1097/GCO.0b013e32835e0ef5 CrossRefPubMed

P. von Dadelszen, B. Payne, J. Li, J.M. Ansermino, F.Broughton Pipkin, A.M. Cote, M.J. Douglas, A. Gruslin, J.A. Hutcheon, K.S. Joseph, P.M. Kyle, T. Lee, P. Loughna, J.M. Menzies, M. Merialdi, A.L. Millman, M.P. Moore, J.M. Moutquin, A.B. Ouellet, G.N. Smith, J.J. Walker, K.R. Walley, B.N. Walters, M. Widmer, S.K. Lee, J.A. Russell, L.A. Magee, Prediction of adverse maternal outcomes in pre-eclampsia: development and validation of the fullPIERS model. Lancet 377(9761), 219–227 (2011). doi:10.1016/S0140-6736(10)61351-7 CrossRef

A.A. Tahrani, C.J. Bailey, S. Del Prato, A.H. Barnett, Management of type 2 diabetes: new and future developments in treatment. Lancet 378(9786), 182–197 (2011). doi:10.1016/S0140-6736(11)60207-9 CrossRefPubMed

K.S. Polonsky, The past 200 years in diabetes. N. Engl. J. Med. 367(14), 1332–1340 (2012). doi:10.1056/NEJMra1110560 CrossRefPubMed

L. Bellamy, J.P. Casas, A.D. Hingorani, D.J. Williams, Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ 335(7627), 974 (2007). doi:10.1136/bmj.39335.385301.BE CrossRefPubMedPubMedCentral

A. Colatrella, V. Loguercio, L. Mattei, M. Trappolini, C. Festa, M. Stoppo, A. Napoli, Hypertension in diabetic pregnancy: impact and long-term outlook. Best Pract. Res. Clin. Endocrinol. Metab. 24(4), 635–651 (2010). doi:10.1016/j.beem.2010.05.003 CrossRefPubMed

10.

M.W. Carpenter, Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes Care 30(Suppl 2), S246–S250 (2007). doi:10.2337/dc07-s224 CrossRefPubMed

11.

E.F. Funai, Y. Friedlander, O. Paltiel, E. Tiram, X. Xue, L. Deutsch, S. Harlap, Long-term mortality after preeclampsia. Epidemiology 16(2), 206–215 (2005)CrossRefPubMed

12.

L. Bellamy, J.P. Casas, A.D. Hingorani, D. Williams, Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. Lancet 373(9677), 1773–1779 (2009). doi:10.1016/S0140-6736(09)60731-5 CrossRefPubMed

13.

T. Kurabayashi, H. Mizunuma, T. Kubota, Y. Kiyohara, K. Nagai, K. Hayashi, Pregnancy-induced hypertension is associated with maternal history and a risk of cardiovascular disease in later life: Japanese cross-sectional study. Maturitas 75(3), 227–231 (2013). doi:10.1016/j.maturitas.2013.04.002 CrossRefPubMed

14.

T. Mannisto, P. Mendola, M. Vaarasmaki, M.R. Jarvelin, A.L. Hartikainen, A. Pouta, E. Suvanto, Elevated blood pressure in pregnancy and subsequent chronic disease risk. Circulation 127(6), 681–690 (2013). doi:10.1161/CIRCULATIONAHA.112.128751 CrossRefPubMedPubMedCentral

15.

E.B. Magnussen, L.J. Vatten, G.D. Smith, P.R. Romundstad, Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet. Gynecol. 114(5), 961–970 (2009). doi:10.1097/AOG.0b013e3181bb0dfc CrossRefPubMed

16.

J.A. Lykke, J. Langhoff-Roos, B.M. Sibai, E.F. Funai, E.W. Triche, M.J. Paidas, Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother. Hypertension 53(6), 944–951 (2009). doi:10.1161/HYPERTENSIONAHA.109.130765 CrossRefPubMed

17.

G. Libby, D.J. Murphy, N.F. McEwan, S.A. Greene, J.S. Forsyth, P.W. Chien, A.D. Morris, Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort. Diabetologia 50(3), 523–530 (2007). doi:10.1007/s00125-006-0558-z CrossRefPubMed

18.

X. Yuan, H. Liu, L. Wang, S. Zhang, C. Zhang, J. Leng, L. Dong, L. Lv, F. Lv, H. Tian, L. Qi, J. Tuomilehto, G. Hu, Gestational hypertension and chronic hypertension on the risk of diabetes among gestational diabetes women. J. Diabetes Complications (2016). doi:10.1016/j.jdiacomp.2016.04.025

19.

K.Y. Heida, A. Franx, B.B. van Rijn, M.J. Eijkemans, J.M. Boer, M.W. Verschuren, M.A. Oudijk, M.L. Bots, Y.T. van der Schouw, Earlier age of onset of chronic hypertension and type 2 diabetes mellitus after a hypertensive disorder of pregnancy or gestational diabetes mellitus. Hypertension 66(6), 1116–1122 (2015). doi:10.1161/HYPERTENSIONAHA.115.06005 PubMed

20.

D.A. Savitz, V.A. Danilack, B. Elston, H.S. Lipkind, Pregnancy-induced hypertension and diabetes and the risk of cardiovascular disease, stroke, and diabetes hospitalization in the year following delivery. Am. J. Epidemiol. 180(1), 41–44 (2014). doi:10.1093/aje/kwu118 CrossRefPubMedPubMedCentral

21.

D. Moher, A. Liberati, J. Tetzlaff, D.G. Altman, Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann. Intern. Med. 151(4), 264–269 (2009). W264CrossRefPubMed

22.

G. Wells, B. Shea, D. O’connell, J. Peterson, V. Welch, M. Losos, P. Tugwell, The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. (2015). http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp

23.

R. DerSimonian, N. Laird, Meta-analysis in clinical trials. Control. Clin. Trials 7(3), 177–188 (1986)CrossRefPubMed

24.

J.P. Higgins, S.G. Thompson, J.J. Deeks, D.G. Altman, Measuring inconsistency in meta-analyses. BMJ 327(7414), 557–560 (2003). doi:10.1136/bmj.327.7414.557 CrossRefPubMedPubMedCentral

25.

M. Egger, G. Davey Smith, M. Schneider, C. Minder, Bias in meta-analysis detected by a simple, graphical test. BMJ 315(7109), 629–634 (1997)CrossRefPubMedPubMedCentral

26.

Q. Hong, S. Yu, X. Geng, L. Duan, W. Zheng, M. Fan, X. Chen, D. Wu, High concentrations of uric acid inhibit endothelial cell migration via miR-663 which regulates phosphatase and tensin homolog by targeting transforming growth factor-beta1. Microcirculation 22(4), 306–314 (2015). doi:10.1111/micc.12200 CrossRefPubMed

27.

I.K. Wang, C.H. Muo, Y.C. Chang, C.C. Liang, C.T. Chang, S.Y. Lin, T.H. Yen, F.R. Chuang, P.C. Chen, C.C. Huang, C.P. Wen, F.C. Sung, D.E. Morisky, Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study. CMAJ 185(3), 207–213 (2013). doi:10.1503/cmaj.120230 CrossRefPubMedPubMedCentral

28.

D.S. Feig, B.R. Shah, L.L. Lipscombe, C.F. Wu, J.G. Ray, J. Lowe, J. Hwee, G.L. Booth, Preeclampsia as a risk factor for diabetes: a population-based cohort study. PLoS Med. 10(4), e1001425 (2013). doi:10.1371/journal.pmed.1001425 CrossRefPubMedPubMedCentral

29.

I.K. Wang, I.J. Tsai, P.C. Chen, C.C. Liang, C.Y. Chou, C.T. Chang, H.L. Kuo, I.W. Ting, C.C. Lin, F.R. Chuang, C.C. Huang, F.C. Sung, Hypertensive disorders in pregnancy and subsequent diabetes mellitus: a retrospective cohort study. Am. J. Med. 125(3), 251–257 (2012). doi:10.1016/j.amjmed.2011.07.040 CrossRefPubMed

30.

A. Engeland, T. Bjorge, A.K. Daltveit, S. Skurtveit, S. Vangen, S.E. Vollset, K. Furu, Risk of diabetes after gestational diabetes and preeclampsia. A registry-based study of 230,000 women in Norway. Eur. J. Epidemiol. 26(2), 157–163 (2011). doi:10.1007/s10654-010-9527-4 CrossRefPubMedPubMedCentral

31.

V.D. Garovic, K.R. Bailey, E. Boerwinkle, S.C. Hunt, A.B. Weder, D. Curb, T.H. Mosley Jr., H.J. Wiste, S.T. Turner, Hypertension in pregnancy as a risk factor for cardiovascular disease later in life. J. Hypertens. 28(4), 826–833 (2010). doi:10.1097/HJH.0b013e328335c29a CrossRefPubMedPubMedCentral

32.

D.B. Carr, K.M. Newton, K.M. Utzschneider, J. Tong, F. Gerchman, S.E. Kahn, T.R. Easterling, S.R. Heckbert, Preeclampsia and risk of developing subsequent diabetes. Hypertens. Pregnancy 28(4), 435–447 (2009). doi:10.3109/10641950802629675 CrossRefPubMed

33.

L.K. Callaway, D.A. Lawlor, M. O’Callaghan, G.M. Williams, J.M. Najman, H.D. McIntyre, Diabetes mellitus in the 21 years after a pregnancy that was complicated by hypertension: findings from a prospective cohort study. Am. J. Obstet. Gynecol. 197(5), 492 e491–e497 (2007). doi:10.1016/j.ajog.2007.03.033 CrossRef

34.

S. Hashemi, F. Ramezani Tehrani, Y. Mehrabi, F. Azizi, Hypertensive pregnancy disorders as a risk factor for future cardiovascular and metabolic disorders (Tehran lipid and glucose study). J. Obstet. Gynaecol. Res. 39(5), 891–897 (2013). doi:10.1111/j.1447-0756.2012.02069.x CrossRefPubMed

35.

R. Marin, M. Gorostidi, C.G. Portal, M. Sanchez, E. Sanchez, J. Alvarez, Long-term prognosis of hypertension in pregnancy. Hypertens. Pregnancy 19(2), 199–209 (2000)CrossRefPubMed

36.

B.M. Sibai, A. el-Nazer, A. Gonzalez-Ruiz, Severe preeclampsia-eclampsia in young primigravid women: subsequent pregnancy outcome and remote prognosis. Am. J. Obstet. Gynecol. 155(5), 1011–1016 (1986)CrossRefPubMed

37.

H.U. Irgens, L. Reisaeter, L.M. Irgens, R.T. Lie, Long term mortality of mothers and fathers after pre-eclampsia: population based cohort study. BMJ 323(7323), 1213–1217 (2001)CrossRefPubMedPubMedCentral

38.

J.G. Ray, M.J. Vermeulen, M.J. Schull, D.A. Redelmeier, Cardiovascular health after maternal placental syndromes (CHAMPS): population-based retrospective cohort study. Lancet 366(9499), 1797–1803 (2005). doi:10.1016/S0140-6736(05)67726-4 CrossRefPubMed

39.

M.E. Samuels-Kalow, E.F. Funai, C. Buhimschi, E. Norwitz, M. Perrin, R. Calderon-Margalit, L. Deutsch, O. Paltiel, Y. Friedlander, O. Manor, S. Harlap, Prepregnancy body mass index, hypertensive disorders of pregnancy, and long-term maternal mortality. Am. J. Obstet. Gynecol. 197(5), 490 e491–e496 (2007). doi:10.1016/j.ajog.2007.04.043 CrossRef

40.

S. Bhattacharya, G.J. Prescott, L. Iversen, D.M. Campbell, W.C. Smith, P.C. Hannaford, Hypertensive disorders of pregnancy and future health and mortality: a record linkage study. Pregnancy. Hypertens 2(1), 1–7 (2012). doi:10.1016/j.preghy.2011.08.116 PubMed

41.

W.C. Wang, A.S. Lien, Y.C. Lai, Y.D. Jiang, Commentary on the effects of gestational hypertension on new-onset diabetes mellitus. J. Diabetes Investig. 4(3), 245–246 (2013). doi:10.1111/jdi.12058 CrossRefPubMedPubMedCentral

42.

G. Shalom, I. Shoham-Vardi, R. Sergienko, A. Wiznitzer, M. Sherf, E. Sheiner, Is preeclampsia a significant risk factor for long-term hospitalizations and morbidity? J. Matern. Fetal Neonatal Med. 26(1), 13–15 (2013). doi:10.3109/14767058.2012.718386 CrossRefPubMed

43.

J.T. Drost, Y.T. van der Schouw, A.H. Maas, W.M. Verschuren, Longitudinal analysis of cardiovascular risk parameters in women with a history of hypertensive pregnancy disorders: the Doetinchem Cohort Study. BJOG 120(11), 1333–1339 (2013). doi:10.1111/1471-0528.12254 CrossRefPubMed

44.

R. Kessous, I. Shoham-Vardi, G. Pariente, R. Sergienko, E. Sheiner, Long-term maternal atherosclerotic morbidity in women with pre-eclampsia. Heart 101(6), 442–446 (2015). doi:10.1136/heartjnl-2014-306571 CrossRefPubMed

45.

M. Feghali, M. Miodovnik, Diabetes: hypertension during pregnancy and future diabetes mellitus. Nat. Rev. Endocrinol. 9(8), 446–447 (2013). doi:10.1038/nrendo.2013.110 CrossRefPubMed

46.

J.C. Hauth, R.G. Clifton, J.M. Roberts, L. Myatt, C.Y. Spong, K.J. Leveno, M.W. Varner, R.J. Wapner, J.M. Thorp Jr., B.M. Mercer, A.M. Peaceman, S.M. Ramin, M.W. Carpenter, P. Samuels, A. Sciscione, J.E. Tolosa, G. Saade, Y. Sorokin, G.D. Anderson, Maternal insulin resistance and preeclampsia. Am. J. Obstet. Gynecol. 204(4), 327 e321–e326 (2011). doi:10.1016/j.ajog.2011.02.024 CrossRef

47.

M. Scioscia, K. Gumaa, T.W. Rademacher, The link between insulin resistance and preeclampsia: new perspectives. J. Reprod. Immunol. 82(2), 100–105 (2009). doi:10.1016/j.jri.2009.04.009 CrossRefPubMed

48.

A. Caruso, S. Ferrazzani, S. De Carolis, A. Lucchese, A. Lanzone, G. Paradisi, Carbohydrate metabolism in gestational diabetes: effect of chronic hypertension. Obstet. Gynecol. 94(4), 556–561 (1999)PubMed

49.

M. Du, A. Basu, D. Fu, M. Wu, M. Centola, A.J. Jenkins, K.F. Hanssen, S.K. Garg, S.M. Hammad, J.A. Scardo, C.E. Aston, T.J. Lyons, Serum inflammatory markers and preeclampsia in type 1 diabetes: a prospective study. Diabetes Care 36(7), 2054–2061 (2013). doi:10.2337/dc12-1934 CrossRefPubMedPubMedCentral

50.

P. Clausen, P. Ekbom, P. Damm, U. Feldt-Rasmussen, B. Nielsen, E.R. Mathiesen, B. Feldt-Rasmussen, Signs of maternal vascular dysfunction precede preeclampsia in women with type 1 diabetes. J. Diabetes Complications 21(5), 288–293 (2007). doi:10.1016/j.jdiacomp.2006.03.004 CrossRefPubMed

51.

A.M. Borzychowski, I.L. Sargent, C.W. Redman, Inflammation and pre-eclampsia. Semin. Fetal Neonatal Med. 11(5), 309–316 (2006). doi:10.1016/j.siny.2006.04.001 CrossRefPubMed

52.

F. Aghajafari, T. Nagulesapillai, P.E. Ronksley, S.C. Tough, M. O’Beirne, D.M. Rabi, Association between maternal serum 25-hydroxyvitamin D level and pregnancy and neonatal outcomes: systematic review and meta-analysis of observational studies. BMJ 346, f1169 (2013). doi:10.1136/bmj.f1169 CrossRefPubMed

53.

W. Wang, X.Q. Ding, T.T. Gu, L. Song, J.M. Li, Q.C. Xue, L.D. Kong, Pterostilbene and allopurinol reduce fructose-induced podocyte oxidative stress and inflammation via microRNA-377. Free Radic. Biol. Med. 83, 214–226 (2015). doi:10.1016/j.freeradbiomed.2015.02.029 CrossRefPubMed

54.

N. Dalbeth, B. Pool, O.M. Shaw, J.L. Harper, P. Tan, C. Franklin, M.E. House, J. Cornish, D. Naot, Role of miR-146a in regulation of the acute inflammatory response to monosodium urate crystals. Ann. Rheum. Dis. 74(4), 786–790 (2015). doi:10.1136/annrheumdis-2014-205409 CrossRefPubMed

55.

W.F. Sun, M.M. Zhu, J. Li, X.X. Zhang, Y.W. Liu, X.R. Wu, Z.G. Liu, Effects of Xie-Zhuo-Chu-Bi-Fang on miR-34a and URAT1 and their relationship in hyperuricemic mice. J. Ethnopharmacol. 161, 163–169 (2015). doi:10.1016/j.jep.2014.12.001 CrossRefPubMed

56.

J. Guo, J.L. Chen, R. Whittemore, E. Whitaker, Postpartum lifestyle interventions to prevent type 2 diabetes among women with history of gestational diabetes: a systematic review of randomized clinical trials. J. Womens Health (Larchmt) 25(1), 38–49 (2016). doi:10.1089/jwh.2015.5262 CrossRef

57.

E.P. Gunderson, S.R. Hurston, X. Ning, J.C. Lo, Y. Crites, D. Walton, K.G. Dewey, R.A. Azevedo, S. Young, G. Fox, C.C. Elmasian, N. Salvador, M. Lum, B. Sternfeld, C.P. Quesenberry Jr., Lactation and progression to type 2 diabetes mellitus after gestational diabetes mellitus: a prospective cohort study. Ann. Intern. Med. 163(12), 889–898 (2015). doi:10.7326/M15-0807 CrossRefPubMedPubMedCentral

58.

M.L. Lie, L. Hayes, N.J. Lewis-Barned, C. May, M. White, R. Bell, Preventing type 2 diabetes after gestational diabetes: women’s experiences and implications for diabetes prevention interventions. Diabet. Med. 30(8), 986–993 (2013). doi:10.1111/dme.12206 CrossRefPubMed

59.

L. Mosca, E.J. Benjamin, K. Berra, J.L. Bezanson, R.J. Dolor, D.M. Lloyd-Jones, L.K. Newby, I.L. Pina, V.L. Roger, L.J. Shaw, D. Zhao, T.M. Beckie, C. Bushnell, J. D’Armiento, P.M. Kris-Etherton, J. Fang, T.G. Ganiats, A.S. Gomes, C.R. Gracia, C.K. Haan, E.A. Jackson, D.R. Judelson, E. Kelepouris, C.J. Lavie, A. Moore, N.A. Nussmeier, E. Ofili, S. Oparil, P. Ouyang, V.W. Pinn, K. Sherif, S.C. Smith, G. Sopko, N. Chandra-Strobos, E.M. Urbina, V. Vaccarino, N.K. Wenger, Effectiveness-based guidelines for the prevention of cardiovascular disease in women-2011 update: A guideline from the american heart association. J. Am. Coll. Cardiol. 57(12), 1404–1423 (2011). doi:10.1016/j.jacc.2011.02.005 CrossRefPubMedPubMedCentral

60.

C. Bushnell, L.D. McCullough, I.A. Awad, M.V. Chireau, W.N. Fedder, K.L. Furie, V.J. Howard, J.H. Lichtman, L.D. Lisabeth, I.L. Pina, M.J. Reeves, K.M. Rexrode, G. Saposnik, V. Singh, A. Towfighi, V. Vaccarino, M.R. Walters, Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the american heart association/american stroke association. Stroke 45(5), 1545–1588 (2014). doi:10.1161/01.str.0000442009.06663.48 CrossRefPubMed

61.

V. Beral, K. Gaitskell, C. Hermon, K. Moser, G. Reeves, R. Peto, Ovarian cancer and smoking: individual participant meta-analysis including 28,114 women with ovarian cancer from 51 epidemiological studies. Lancet Oncol. 13(9), 946–956 (2012). doi:10.1016/s1470-2045(12)70322-4 CrossRefPubMed

62.

L. Stewart, M. Parmar, Meta-analysis of the literature or of individual patient data: is there a difference? Lancet 341(8842), 418–422 (1993)CrossRefPubMed

Titel: Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis
verfasst von: Zengfang Wang
Zengyan Wang
Luang Wang
Mingyue Qiu
Yangang Wang
Xu Hou
Zhong Guo
Bin Wang
Publikationsdatum: 12.08.2016
Verlag: Springer US
Erschienen in: Endocrine / Ausgabe 3/2017
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-016-1075-6

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Innere Medizin

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Bei schweren Reaktionen auf Insektenstiche empfiehlt sich eine spezifische Immuntherapie

25.04.2024 Allergien und Intoleranzreaktionen Nachrichten

Insektenstiche sind bei Erwachsenen die häufigsten Auslöser einer Anaphylaxie. Einen wirksamen Schutz vor schweren anaphylaktischen Reaktionen bietet die allergenspezifische Immuntherapie. Jedoch kommt sie noch viel zu selten zum Einsatz.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2017

Ghrelin is independently associated with anti-mullerian hormone levels in obese but not non-obese women with polycystic ovary syndrome

Thyroid hormone levels in the cerebrospinal fluid correlate with disease severity in euthyroid patients with Alzheimer’s disease

Rationale and design of the Early Sleeve gastrectomy In New Onset Diabetic Obese Patients (ESINODOP) trial

AT1 receptor antagonist induces thermogenic beige adipocytes in the inguinal white adipose tissue of obese mice

Role of cannabinoid receptor 1 in human adipose tissue for lipolysis regulation and insulin resistance