RELATIONSHIP BETWEEN GLUCOSE METABOLISM AND MICROALBUMINURIA IN WOMEN WITH PRIOR GESTATIONAL DIABETES: PP.17.158

Abstract

Aims: Relationship between glucose abnormalities and microalbuminuria in women with pGDM.W. Methods: We prospectively studied 215 women with pGDM. According to OGTT, we divided into two groups: pGDM with normal glucose tolerance post-partum (NG) (66,8%) and pGDM with abnormal glucose tolerance post-partum (AG) (33,2%). Insulin sensitivity was derived using HOMA. Metabolic syndrome (MS) was defined by ATP-III We collected obstetric history, personal history of pGDM and personal and family history of cardiovascular risk factors. Microalbuminuria and glomerular filtration by MDRD were measured. Results: Mean age was 33,45 ± 4,5 yrs.; 26,25% smoking, 15,6% history of dyslipemia, 30% had history of previous abortions. 62,34% of women had first-degree relatives with type 2 DM and 59,25% had family history of hypertension The prevalence of MS was higher (32,3%) in AG group than in NG (14,7 %); p < 0.005. In addition, AG group had higher values of BMI and WC vs. NG group (28,86 ± 4,5 vs 22,70 ± 3,1 Kg/m2; p < 0.005 and 93,76 ± 6,1 vs 80,34 ± 4,6; p < 0.05, respectively). Fasting glucose and 2h-glucose levels were higher in AG group than NG (98,85 ± 7,7 vs 80,2 ± 5,6 mg/dl, p < 0.005 and 166,57 ± 23 vs 119,4 ± 20 mg/dl). Fasting insulin and HOMA values were significantly higher in AG than NG; p < 0.005. Microalbuminuria levels in AG group were greater (29.4 ± 13 mg/24 h) vs NT (11.67 ± 4,7 mg/24 h; p < 0.05). No differences in renal function. In addition, AG group presented a higher prevalence of family history of type 2 DM (68,7% vs 48%, p < 0.01). Conclusion: Women with pGDM have a high prevalence of abnormal glucose tolerance and MS and lower values of adiponectin, particularly those with AG (and with higher levels of microalbuminuria). Thus women with pGDM and family history of type 2 DM may be especially suitable interventions aimed at preventing or reducing type 2 DM and probably cardiovascular events.