Association Between Gestational Diabetes History with Endometrial Hyperplasia and Cancer

Background & Objective: Gestational diabetes mellitus (GDM) is also defined as a metabolic disease associated with relative insulin resistance during pregnancy, and elevated circulating insulin may increase the risk of EH and EC development. This study aimed to investigate the association between GDM and the incidence of EH and EC. Materials & Methods: We conducted a retrospective case-control study, including ۳۰۰ women with abnormal uterine bleeding (AUB) referred to Ayatollah Rouhani Hospital in Babol. Cases (n=۱۵۲) were patients with HC and EC based on medical records, and the controls (n=۱۴۸) were individuals without HC and EC. The groups were compared according to demographic information, GDM or diabetes mellitus (DM) history, and body mass index (BMI). The Chi-square, independent t-test, and logistic regression analyses were performed to compare groups. Results: Of ۳۰۰ women studied, ۷۲ people (۲۴.۱%) had a GDM history, and ۶۴ people had a diabetes mellitus history. There was a significant difference between the incidence of EC and EH with GDM (P=۰.۰۰۱). Both GDM and DM were associated with the increased EC (OR: ۱۷.۹۸, ۹۵% CI: ۶.۷۳-۴۸.۰۸, and OR: ۱.۸۴, ۹۵% CI: ۱.۲۶-۲.۶۸, respectively). GDM was also associated with the increased risk of EH (OR: ۶.۶۸, ۹۵% CI: ۲.۷۷-۱۶.۱۰), whereas diabetes mellitus had not a significant role in the increased risk of EH (P=۰.۱۴). Conclusion: This study indicated that a GDM history is significantly associated with HC and EC. Therefore, to prevent and control these two complications in the future, management and monitoring of diabetes during pregnancy should be considered.

Keywords:

Gestational diabetes , Endometrial cancer , Endometrial hyperplasia , Insulin resistance