Previous history of gestational diabetes mellitus and flow mediated dilation of brachial artery
S Alatab, H Fakhrzadeh, F Sharifi, M Mirarefein, Z Badamchizadeh, M Ghaderpanahi, A Hashemi Taheri & B Larijani
Background: Gestational diabetes mellitus (GDM) is a common pregnancy condition which is associated with long term complications. In this study we examined the levels of inflammatory mediators, adiponectin, hemocystein and insulin resistance index in women with and without previous GDM (pGDM). Also association between these factors and early atherosclerosis process was evaluated.
Methods: Serum levels of IL6, hs-CRP, adiponectin, homocystein and other biomedical parameters were measured in 40 women with and without pGDM. The average time passed from the index pregnancy was 4 years (range 15 years). Two groups were matched based on age, BMI and years after affected pregnancy. The existence of early atherogenesis process was evaluated by measuring both CIMT and FMD. FMD was measured according to guidelines of American College Cardiology. The Levenes test was used for assessing the equality of variances. Pearson correlation was used to investigate the correlation between quantities variables.
Results: Even not hypertensive, the mean of systolic and diastolic blood pressure in pGDM group was significantly higher (P<0.04). Lipid profile, fasting blood sugar, hs-CRP, IL6, adiponectin and homocyteine levels did not significantly different between two groups. However fasting insulin (6.44±4.52 vs 10.19±5.04, P<0.01) and insulin resistance index as was measured by the homeostatic model assessment (HOMA; 1.41±1 vs 2.33±1.2, P<0.01) were significantly higher in pGDM group. Women with pGDM had slightly, however, not significantly, higher CIMT and significantly lower percent of brachial FMD (26±0.11 vs 19.32±0.05%, P<0.02). FMD and CIMT, adjusted for age and blood pressure, still showed the same pattern. No correlation between inflammatory markers, adiponectin and homocystein and FMD was found.
Conclusion: Women with pGDM are at increased risk of developing insulin resistance and premature atherosclerosis process despite of any change in lipid profile or being hypertensive. Early follow up with FMD should be considered in this group of women.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.