TABLE 3.
Unadjusted cardiometabolic outcomes at follow-up according to artificially sweetened beverage intake at follow-up among women with a history of gestational diabetes1
| Habitual artificially sweetened beverage intake at follow-up (2012–2014)2 | ||||||
|---|---|---|---|---|---|---|
| n | (n = 197) | (n = 88) | (n = 214) | (n = 87) | P 3 | |
| Continuous outcomes (2012–2014) | ||||||
| HbA1c, % | 603 | 5.4 (5.2, 5.6) | 5.3 (5.1, 5.7) | 5.5 (5.2, 5.9) | 5.5 (5.2, 6.1) | 0.003* |
| Fasting glucose, mmol/L | 603 | 5.4 (5.0, 5.9) | 5.4 (5, 5.9) | 5.5 (5.1, 6.2) | 5.5 (5, 6.2) | 0.08 |
| Fasting insulin, pmol/L | 600 | 44.0 (31.0, 68.0) | 48.5 (36.0, 78.5) | 52.0 (36.0, 80.0) | 57.0 (43.0, 86.0) | <0.001* |
| C-peptide, pmol/L | 601 | 891.0 (699.6, 1181.4) | 973.5 (782.1, 1280.4) | 970.2 (755.7, 1240.8) | 1069.2 (844.8, 1221) | 0.09 |
| HOMA-IR | 599 | 1.5 (1.0, 2.3) | 1.6 (1.3, 2.7) | 1.9 (1.2, 3.1) | 2.1 (1.5, 3.6) | <0.001* |
| HOMA-B | 599 | 66.0 (44.0, 96.8) | 71.7 (54.1, 98.5) | 73.9 (48.3, 105.2) | 82.6 (58.5, 108.4) | 0.13 |
| Triglycerides, mg/dL | 601 | 95.0 (72.0, 136.0) | 93.5 (75.5, 133.5) | 107.0 (84.5, 155.5) | 116.0 (90.0, 173.0) | <0.001* |
| HDL, mg/dL | 601 | 60.0 (50.0, 71.0) | 59.0 (49.0, 70.0) | 55.0 (47.0, 67.0) | 54.0 (47.0, 62.0) | 0.003* |
| LDL, mg/dL | 592 | 120.0 (97.0, 143.0) | 107.5 (92.5, 128.0) | 111.0 (94.0, 133.0) | 114.0 (89.0, 134.0) | 0.06 |
| BMI, kg/m2 | 606 | 25.7 (23.1, 29.9) | 29.2 (24.9, 33.3) | 29.1 (25.4, 33.3) | 31.4 (27.0, 34.9) | <0.001* |
| Waist circumference, cm | 606 | 94.2 (86.3, 103.8) | 99.5 (92.2, 111.9) | 100.6 (90.6, 108.6) | 105.1 (96.6, 114.3) | <0.001* |
| Visceral adipose tissue, cm3 | 192 | 692.0 (348.0, 1113.0) | 677.0 (357.0, 1109.0) | 701.0 (413.0, 1319.0) | 821.5 (379.5, 1434.0) | 0.73 |
| Mean arterial pressure, mm Hg | 607 | 89.8 (83.7, 97.8) | 89.9 (84.2, 99.8) | 90.8 (84.5, 100.0) | 95 (87.7, 104.8) | 0.01* |
| CRP, mg/L | 600 | 1.3 (0.5, 2.9) | 1.3 (0.6, 3.7) | 1.8 (0.7, 4.3) | 2.5 (0.9, 4.6) | 0.008* |
| ALT, U/L4 | 284 | 19.0 (16.0, 24.0) | 18.0 (15.0, 29.0) | 21.0 (16.0, 25.0) | 19.0 (17.0, 28.0) | 0.22 |
| AST, U/L4 | 283 | 29.0 (24.0, 34.0) | 25.0 (21.0, 33.0) | 29.0 (24.0, 35.0) | 28.0 (24.0, 35.0) | 0.15 |
| AST:ALT ratio4 | 283 | 1.6 (1.2, 1.8) | 1.4 (1.0, 1.6) | 1.4 (1.2, 1.7) | 1.4 (1.2, 1.7) | 0.049* |
| Liver fat, %4,5 | 280 | 2.6 (1.9, 5.3) | 2.6 (1.7, 6.2) | 3.7 (2.2, 7.3) | 4.3 (2.2, 7.3) | 0.04* |
| GGT, U/L4 | 286 | 17.0 (13.0, 26.0) | 18.0 (12.0, 38.0) | 19.0 (13.0, 28.0) | 22.0 (14.0, 35.0) | 0.44 |
| Bilirubin, mg/dL4 | 285 | 0.3 (0.3, 0.6) | 0.4 (0.3, 0.5) | 0.4 (0.3, 0.5) | 0.3 (0.3, 0.4) | 0.67 |
| Binary outcomes at follow-up (2012–2014)6 | ||||||
| Hyperglycemia | 603 | 11 (5.6) | 7 (8.0) | 31 (14.5) | 13 (14.9) | 0.01* |
| Type 2 diabetes | 607 | 39 (19.8) | 20 (22.7) | 68 (31.8) | 28 (32.2) | 0.02* |
| Hypertriglyceridemia | 601 | 13 (6.6) | 4 (4.6) | 22 (10.3) | 12 (13.8) | 0.08 |
| Obesity | 606 | 48 (24.4) | 36 (40.9) | 93 (43.5) | 54 (62.1) | <0.001* |
| Elevated ALT 4 | 284 | 40 (50.6) | 18 (46.2) | 62 (62.0) | 34 (58.6) | 0.23 |
| Elevated AST:ALT ratio4 | 284 | 14 (17.7) | 2 (5.1) | 10 (10.0) | 7 (12.1) | 0.20 |
| Elevated liver fat score4,7 | 280 | 25 (31.7) | 16 (41.0) | 48 (48.0) | 32 (55.2) | 0.03* |
Data presented as mean (SD), median (IQR), or n (%), as applicable. All values are unadjusted. *Statistical significance, P < 0.05. ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; fs, fasting serum; GGT, γ-glutamyltransferase; HOMA-B, homeostatic model assessment for β-cell function; T2DM, type 2 diabetes mellitus.
Outcomes not shown for the 28 women missing artificially sweetened beverage intake at follow-up.
P values for parametric continuous variables calculated using ANOVA; P values for nonparametric continuous variables calculated using Wilcoxon 2-sample test statistic; and P values for categorical variables calculated using chi-square test statistic or Fisher's exact test, as applicable.
Outcomes related to liver function exclude women with habitual alcohol intake at follow-up of >24 g/d, approximately equivalent to 2 standard drinks/d.
Calculated liver fat % = 10(−0.805 + 0.282 × metabolic syndrome (yes = 1; no = 0) + 0.078 × T2DM (yes = 2; no = 0) + 0.525 × log(fs-insulin [mU/L]) + 0.521 × log(fs-AST [U/L]) – 0.454 × log(AST/ALT)).
The following definitions were used for the binary outcomes: elevated ALT, ≥19.0 U/L; elevated AST:ALT ratio, ratio ≥2; elevated liver fat score, > −0.640; hypertriglyceridemia, triglycerides ≥200 mg/dL; hyperglycemia, fasting glucose ≥7.0 mmol/L; type 2 diabetes, HbA1c ≥6.5%, fasting glucose ≥7.0 mmol/L, or 2-h oral glucose tolerance test glucose ≥11.1 mmol/L or self-report of physician diagnosis; obesity, BMI ≥30.0.
Liver fat score = −2.89 + 1.18 × metabolic syndrome (yes = 1/no = 0) + 0.45 × T2DM (yes = 2/no = 0) + insulin (mU/L) + 0.04 × AST (U/L) – 0.94 × AST/ALT.