Abstract

Objective. We hypothesised that the endothelial dysfunction is associated with early glucose dysregulation and/or atherosclerosis risk factors in nondiabetic women with a previous history of gestational diabetes (pGDM). Material/Methods. Anthropometric parameters, glucose regulation (OGTT), insulin resistance (HOMA), lipids, biomarkers of endothelial dysfunction, and inflammation were evaluated in 85 women with pGDM and in 40 controls 2–24 months postpartum. Results. The pGDM group consisted of 67% normoglycemic women (pGDM-N) and 33% with prediabetic state (pGDM-P). The BMI, waist circumference, fasting and 2 h glucose (OGTT), soluble adhesion molecules, tissue plasminogen activator antigen, high sensitivity C-reactive protein, total-, LDL-cholesterol, and triglycerides/HDL-cholesterol ratio were higher in the pGDM women compared with the controls. After adjustment for BMI and fasting glucose, only higher triglycerides, higher TG/HDL and lower HDL-cholesterol were associated with pGDM. The pGDM-P differed from pGDM-N for only higher triglycerides and TG/HDL. The plasma level of sE-selectin was not independently associated with glucose concentration in pGDM group. sE-selectin level correlated with triglycerides, TG/HDL, plasminogen activator inhibitor-1 antigen, and sICAM-1. Conclusions. sE-selectin level correlated with components of metabolic syndrome, but only the atherogenic lipid profile was independently associated with a previous history of GDM in nondiabetic women 2–24 months postpartum.

Highlights

  • Women with the previous history of gestational diabetes mellitus have a significantly increased risk of type 2 diabetes and cardiovascular disease in the years after delivery [1]

  • Conclusions. sE-selectin level correlated with components of metabolic syndrome, but only the atherogenic lipid profile was independently associated with a previous history of GDM in nondiabetic women 2–24 months postpartum

  • Our study shows that these nondiabetic women with previous history of gestational diabetes mellitus (pGDM) have higher concentrations of cardiovascular risk factors at average 10 months assessment after delivery in comparison with women with normal glucose regulation during pregnancy

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Summary

Introduction

Women with the previous history of gestational diabetes mellitus (pGDM) have a significantly increased risk of type 2 diabetes and cardiovascular disease in the years after delivery [1]. Women with pGDM have an increased cardiometabolic derangement, including vascular risk factors and early vascular dysfunction [2,3,4]. Several studies performed early (6 weeks-2 years) after delivery have found the association of cardiovascular risk factors with glucose intolerance, and in particular with type 2 diabetes [5, 6]. It is possible that different stages of glucose dysregulation diagnosed during pregnancy are associated with early cardiovascular risk postpartum [7]. It has been suggested that the association between prediabetic state or diabetes and cardiovascular disease may be mediated through endothelial dysfunction [8, 9]

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