The study of incidence of metabolic syndrom in patients with previous gestational diabetes mellitus and the association of metabolic syndrome with inflammatory mediators as well as other factors

Abstract

Objective To investigate the incidence of metabolic syndrome in patients with previous gestational diabetes (GDM) and the association of C-reactive protein (CRP),serum amyloid A (SAA) and other factors with metabolic syndrome two years after delivery.Methods A total of 120 pregnant women who went to Tianjin central obstetrics and gynecology hospital for delivery from July 2010 to December 2010 were collected into the nested case-control cohort.Patients with previous GDM were classified into case group(n =60),and sixty women who went to the hospital for delivery without GDM over the same period were classified into control group.We collected data from July 2011 to December 2012 by means of refering to document,anthropometric and laboratory tests.The anthropometric items included height,weight,waist,hip circumference,blood pressure and body fat.The laboratory tests included fast blood glucose,triglyceride(TG),total cholesterol (TC),low density lipoprotein-cholesteral(LDL-C),high density lipoprotein-cholesterol(HDL-C),HbA1c,homeostatic model assessment of insulin resistance (HOMA-IR),SAA and CRP.SAA was determined by means of ELISA and CRP was determined by the method of immunonephelometry.Results The two groups were comparable in the factors of family economic status,blood pressure,TG and TC.The pregnancy age,fetal birth weight,pre-pregnancy body mass index (BMI),body fat and waist-hip ratio of case group were higher than those in control group(P all ＜ 0.05).Besides,the ratio of family history of diabetes and cardiovascular disease of case group were higher than those in the control group(P ＜ 0.05).Two years after delivery,the incidence of metabolic syndrome of case group(18.3％,11/60) was higher than that in the control group(5.0％,3/60) (OR =5.175,P =0.023).BMI,body fat,waist circumference,waist-hip ratio,TC,LDL-C,HOME-IR,HbA1c,SAA and CRP of case group were signifantly higher than those in the control group (P ＜ 0.05).The multiple logistic regression revealsed that high pregnancy age (OR =1.369,P =0.000),high pre-pregnancy BMI (OR =1.199,P =0.000),diabetes family history (OR =1.223,P =0.000),high fetal birth weight (OR =1.267,P =0.015),previous GDM (OR =2.824,P =0.000) were risk factors of metabolic syndrome after delivery.SAA and CRP were positively associated with the numbers of components of metabolic syndrome (F =38.625,P ＜ 0.01).Conclusions Both SAA and CRP may participate in the chronic inflammatory state of metabolic syndrome.Determining them cominbing with family history of diabetes and pregnancy age might be an applicable means for predicting metabolic syndrome in previous GDM women. Key words: Gestational diabetes mellitus; Metabolic syndrome; C-reactive protein; Serum amyloid A