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However, bone health of women with a history of gestational diabetes (GDM) has received little attention. This cross\u2010sectional study compares bone health between premenopausal women with and without a history of GDM, and examines factors associated with bone health in women with a history of GDM or obesity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>We measured areal bone mineral density for total hip, lumbar spine and whole body, and total body fat percentage (fat%) with dual\u2010energy X\u2010ray absorptiometry in 224 women. In addition, we measured bone characteristics of radius and tibia with peripheral quantitative computed tomography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>When compared with women without a history of GDM (mean age 39\u00a0years [SD 5], body mass index [BMI] 35\u00a0kg\/m<jats:sup>2<\/jats:sup> [SD 6], fat% 48 [SD 7]), women with a history of GDM (age 41\u00a0years [SD 4], BMI 31\u00a0kg\/m<jats:sup>2<\/jats:sup> [SD 7], fat% 43 [SD 10]) had lower hip and whole body bone mineral densities, and inferior tibia outcomes. However, the differences in bone characteristics disappeared after controlling for age, height, BMI and fat%. After controlling for age, height, BMI and smoking, physical activity and healthier diet were positively associated with bone outcomes, whereas fat%, HbA<jats:sub>1c<\/jats:sub> and screen time were negatively associated with bone outcomes. Particularly, fat% showed independent negative associations with whole body bone mineral density and several tibia and radius characteristics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Fat% is associated with adverse bone health, independently of BMI, in women with a history of GDM or obesity. Promoting healthy lifestyle and reducing fat% in high\u2010risk\u00a0women could improve bone health and prevent future fractures.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.13778","type":"journal-article","created":{"date-parts":[[2019,12,2]],"date-time":"2019-12-02T09:56:36Z","timestamp":1575280596000},"page":"477-487","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Bone health in women with a history of gestational diabetes or obesity"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8713-5607","authenticated-orcid":false,"given":"Elina","family":"Engberg","sequence":"first","affiliation":[{"name":"Folkh\u00e4lsan Institute of Genetics Folkh\u00e4lsan Research Center Helsinki Finland"},{"name":"Department of Sports and Exercise Medicine Clinicum Faculty of Medicine University of Helsinki Helsinki 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