Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes.

Abstract

OBJECTIVE:

To investigate whether baseline triglyceride levels are associated with early glucose dysregulation and/or cardiovascular risk in women with a previous history of gestational diabetes.

DESIGN:

Prospective postpregnancy cohort study.

SETTING:

Polish university hospitals.

SAMPLE:

Participants included 125 women with previous gestational diabetes and 40 women with normal glucose regulation during pregnancy.

METHODS:

All women were studied 2-24 months (mean 12 ± 10 months) after the index pregnancy. Women with previous gestational diabetes were divided into tertiles in accordance with baseline triglyceride levels.

MAIN OUTCOME MEASURES:

We assessed glucose regulation (oral glucose tolerance test), insulin resistance (homeostasis model assessment), markers of endothelial dysfunction (soluble: intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, tissue plasminogen activator antigen, von Willebrand factor antigen), fibrinolysis (plasminogen activator inhibitor antigen), inflammation (high-sensitivity C-reactive protein) and lipid levels.

RESULTS:

Women with previous gestational diabetes (78% normal glucose regulation, 22% impaired glucose tolerance) had a high cardiometabolic risk profile compared with control women (100% normal glucose regulation). Baseline triglycerides >0.83 mmol/l were associated with a higher prevalence of impaired glucose tolerance, higher high-sensitivity C-reactive protein and triglyceride/high-density lipoprotein-cholesterol ratio. Triglycerides >1.22 mmol/l were associated with higher body fat indexes, higher insulin resistance, higher levels of endothelial dysfunction biomarkers, higher plasminogen activator inhibitor antigen and dyslipidemia. Only E-selectin was independently associated with triglyceride levels.

CONCLUSIONS:

Baseline triglyceride levels are a cardiovascular risk marker as well as a pathophysiological parameter independently associated with endothelial dysfunction in nondiabetic women with previous gestational diabetes at 2-24 months after an index pregnancy. Normalization of triglycerides should be included in preventive therapy after a pregnancy complicated by gestational diabetes.

• Authors: Alina Sokup, Barbara Góralczyk, Krzysztof Góralczyk, Danuta Rość
• Journal: Acta obstetricia et gynecologica Scandinavica (Acta Obstet Gynecol Scand) Vol. 91 Issue 2 Pg. 182-8 (Feb 2012) ISSN: 1600-0412 [Electronic] United States
• PMID: 21954994 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Chemical References

• Biomarkers
• Blood Glucose
• E-Selectin
• Insulin
• Plasminogen Activator Inhibitor 1
• SELE protein, human
• SERPINE1 protein, human
• Triglycerides
• Vascular Cell Adhesion Molecule-1
• Von Willebrand antigen
• von Willebrand Factor
• Intercellular Adhesion Molecule-1
• C-Reactive Protein
• Cholesterol
• Tissue Plasminogen Activator

Topics

• Adult
• Biomarkers (blood)
• Blood Glucose (metabolism)
• C-Reactive Protein (metabolism)
• Case-Control Studies
• Cholesterol (blood)
• Diabetes, Gestational
• E-Selectin (blood)
• Endothelium, Vascular (physiopathology)
• Female
• Glucose Metabolism Disorders (blood, etiology)
• Humans
• Insulin (blood)
• Intercellular Adhesion Molecule-1 (blood)
• Plasminogen Activator Inhibitor 1 (blood)
• Postpartum Period (blood)
• Pregnancy
• Prospective Studies
• Risk Factors
• Tissue Plasminogen Activator (blood)
• Triglycerides (blood)
• Vascular Cell Adhesion Molecule-1 (blood)
• Vascular Diseases (blood, etiology)
• von Willebrand Factor (immunology, metabolism)