Abstract
AimTo compare microvascular reactivity assessed in the skin using laser Doppler fluximetry (LDF) in women with gestational diabetes mellitus (GDM) and gestational age-matched control during pregnancy.Methods110 pregnant women at ~33 weeks gestation participated in the study. Skin microvascular reactivity was evaluated by LDF, at rest, during the response to brief arterial occlusion (post occlusive hyperaemic response) and during sympathetically mediated vasoconstrictor response to deep inspiratory breath hold.ResultsNo statistically significant differences were found in the microvascular variables studied (resting and maximum rate flux, post-ischaemic reactive hyperaemia and deep inspiratory breath holds) between +GDM and –GDM groups women. In women with GDM there was a negative correlation between resting flux and the response to the oral glucose tolerance test (OGTT), r = -0.282 (p = 0.037). There was also a negative correlation between the response to the OGTT and the sympathetically mediated constrictor response to inspiratory breath holds (r = -.298, p = .030) but not in women with GDM (r = .102, r = .468).ConclusionAttenuated microvascular reactivity as an early marker of endothelial dysfunction is not present in women with GDM when assessed during pregnancy.
Highlights
Concurrent with the rising prevalence of obesity, especially among women of reproductive age, the prevalence of gestational diabetes mellitus (GDM) is increasing and has been a health concern worldwide [1]
198 pregnant women were enrolled in the study and 144 were eligible; 54 were excluded by blood hypertension, type 1 or type 2 diabetes or twin pregnancy
In this study we found no differences in microvascular reactivity between women with and without GDM when assessed during pregnancy
Summary
Concurrent with the rising prevalence of obesity, especially among women of reproductive age, the prevalence of gestational diabetes mellitus (GDM) is increasing and has been a health concern worldwide [1]. Women with a history of GDM have a 70% higher incidence of cardiovascular disease (CVD) as compared to their peers and even milder gestational impaired glucose tolerance has been associated with an enhanced cardiovascular risk factor profile and subsequent type 2 diabetes [4,5]. Impaired endothelium-dependent relaxation in larger blood vessels has been observed in women with a history of GDM assessed months or years after delivery in some but not all studies and these findings remain controversial [9,10,11,12]. Impaired microvascular responses have been reported in women with previous GDM studied some years after pregnancy [11,13] suggesting that abnormal microvascular function could represent a novel mechanism contributing to the elevated risk of CVD in these women. Microvascular responses have yet to be fully evaluated during pregnancy in women newly diagnosed with GDM
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