Endocrine Abstracts

Women with a history of GDM may be at increased risk for future diabetes and cardiovascular disease. The aim of this study was to investigate the endothelium dependent hemostatic factors as well as the parameters of endothelial function and inflammation in women with pGDM.

Eighty women with pGDM and 40 women (control) healthy women with normal glucose tolerance during pregnancy were studied. In all women, plasma glucose, insulin, C-peptid, lipid profile, CRP and endothelium dependent hemostatic factors PAI–1, vWF, fibrinogen, tissue factor (TF), t-PA, total TFPI were measured.

Subjects with pGDM and healthy control subjects did not differ in mean age or number of years postpartum. The women with a pGDM had higher fasting glucose, postprandial glucose, total cholesterol, LDL-cholesterol, and triglyceride levels than women with a history of normal pregnancy; homeostasis model assessment, insulin and C-peptid were also higher in the pGDM group. Compared with the control group, women with a pGDM had higher levels of CRP, fibrinogen, PAI-1, TF, and total TFPI. After adjusting for BMI, CRP and PAI–1 remained higher in the women with pGDM. PAI–1 levels correlated with BMI, WHR, LDL-cholesterol, triglyceride, HDL-cholesterol, fasting glucose, 2 h plasma glucose, insulin, HOMA-IR, CRP and TF in the whole group.

The increase of endothelium dependent hemostatic factors and inflammatory markers may be one of the first detectable markers in high risk of diabetes, like those with a pGDM. Higher levels of fibrinogen, PAI–1, TF and TFPI in particular may help to explain this higher prevalence of diabetes in pGDM subjects.