Gestational diabetes mellitus (GDM) is associated with an increased risk of pregnancy-induced hypertension (PIH). Ambulatory blood pressure monitoring (ABPM) has been used to screen for PIH and preeclampsia. To date, there are no data regarding ABPM in women with GDM. Currently, little is known in GDM about the role of inflammatory biomarkers in PIH development and their impact on perinatal morbility and the risk of future complications. With this study we aim to identify, in women with GDM, at an early stage inflammatory markers and BP profiles (detected by ABPM) that could define a population at higher risk of developing PIH and preeclampsia. We prospectively studied 113 normotensive women with GDM consecutively recruited at 2832 weeks of pregnancy. ABPM was carried out for one 24-h period on each patient, using the SPACELABS 90207 ABP monitor. Serum biomarkers (PAI-1, IL-6, IL-8, leptin, IL1-β, TNF-α, adiponectin, resistin, NGF, HGF and MCP1) were determinated in 61 patients by MILLIPLEX kit. Clinical and metabolic data, obstetric and perinatal outcomes were analysed. The mean age was 34.4±4.2 years and BMI was 27.5±5.3 kg/m2. Fifty-six percent of the patients had non-dipper pattern. In this group, BMI was significantly higher (P<0.05) and the levels of night-time systolic (105.3 vs 98.8 mmHg) and diastolic BP (63.1 vs 57.2 mmHg), and furthermore, higher levels of PAI-1 (296.99±161.3 vs 162.07±117.52 pg/ml) and resistin (175.69±92.17 vs 101.74±64.34 pg/ml) were observed. Seventy-eight women delivered to date, 3% had preeclampsia and 7% PIH. Higher levels of adiponectin (125 992.7±94 472.4 vs 39 850±31 136 pg/ml) were observed in patients who not develop PIH. We concluded that a higher rate of non-dippers pattern and night-time systolic/diastolic BP were observed. The non-dipper group had higher BMI and levels of PAI-1 and resistin, which could be a useful predictor of PIH. Adiponectin was significantly lower in patients with PIH and then could point at a protective mechanism in PIH. Further studies will be needed to determine the relationships between BP alterations and inflammatory markers, and obstetrics and perinatal outcomes.
20 - 23 May 2017
European Society of Endocrinology