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Arterial stiffness, inflammatory and pro-atherogenic markers in gestational diabetes mellitus.

Abstract

BACKGROUND
This study aims to determine whether gestational diabetes mellitus (GDM) is associated with increased arterial stiffness, inflammatory and pro-atherogenic markers compared to age matched controls.
PATIENTS AND METHODS
This is a cross-sectional study involving 53 pregnant women in the early third trimester of pregnancy consisting of 31 women with normal pregnancy and 22 women with GDM. Subjects were grouped into GDM and control groups based on modified oral glucose tolerance test results; they were considered GDM if fasting blood glucose (FBG) was ≥ 6.1 mmol/L and/or the two hours post-glucose intake was ≥ 7.8 mmol/L. Arterial stiffness was assessed non-invasively using the parameters augmentation index (AIx) obtained via pulse wave analysis and carotid femoral pulse wave velocity (PWV). Tumor necrosis factor alpha (TNF-alpha), high sensitivity C- reactive protein (hsCRP) and plasminogen activator inhibitor-1 (PAI-1) were measured using enzyme linked immunoassay technique (ELISA). Aortic and brachial blood pressure (BP) indices were also recorded.
RESULTS
Mean ages and gestational ages (GA) for the control and GDM groups showed no significant differences (31.1 ± 5.68 vs. 32.9 ± 8.46 years; 29.0 ± 2.43 vs. 29.6 ± 1.54 weeks respectively). FBG and 2 hour post-glucose levels were significantly higher in GDM; (5.27 ± 1.19 vs. 3.94 ± 0.44 mmol/L, p < 0.001; 9.66 ± 1.76 vs. 5.68 ± 1.10 mmol/L, p < 0.001). TNF-alpha, PAI-1 and hsCRP levels were significantly higher in GDM compared to controls (0.81 ± 0.15 vs. 0.72 ± 0.13 pg/ml, 54.48 ± 13.07 vs. 36.16 ± 15.58 cm/ml, 7.91 ± 1.16 vs. 6.70 ± 1.45 mg/l respectively). PWV (8.28 ± 1.48 vs. 7.97 ± 1.12) and AIx (16.73 ± 10.98 vs. 16.13 ± 9.64 %) were not significantly different between the two groups. No significant differences were seen for aortic and brachial BP, mean arterial pressure and body mass index.
CONCLUSIONS
The inflammatory markers TNF-alpha and hsCRP, and the pro-atherogenic marker PAI-1 were elevated in GDM compared to age matched controls. No significant difference was seen between the two groups in their arterial stiffness.

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  • Publisher Full Text
  • Authors

    Salmi AA, Zaki NM, Zakaria R, Nor Aliza AG, Rasool AH

    Source

    VASA. Zeitschrift für Gefässkrankheiten 41:2 2012 Mar pg 96-104

    MeSH

    Adult
    Analysis of Variance
    Biological Markers
    Blood Glucose
    Blood Pressure
    C-Reactive Protein
    Carotid Arteries
    Case-Control Studies
    Compliance
    Cross-Sectional Studies
    Diabetes, Gestational
    Enzyme-Linked Immunosorbent Assay
    Female
    Femoral Artery
    Gestational Age
    Glucose Tolerance Test
    Humans
    Inflammation Mediators
    Malaysia
    Plasminogen Activator Inhibitor 1
    Predictive Value of Tests
    Pregnancy
    Pregnancy Trimester, Third
    Prospective Studies
    Pulsatile Flow
    Tumor Necrosis Factor-alpha
    Up-Regulation

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22403127