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Fibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetes.
Diabetes Res Clin Pract. 2007 Dec; 78(3):340-8.DR

Abstract

Among patients with metabolic syndrome (MS), atherosclerosis and abnormal fibrinolytic function are frequently present, mostly owing to an increase in plasminogen activator inhibitor-1(PAI-1). We analyze PAI-1 in pregnant women, both normal and with gestational diabetes (GDM) and postpartum regarding its correlation to MS surrogates. Clinical characteristics, glucose tolerance (100g-OGTT), lipids, PAI-1 antigen, insulin sensitivity (HOMA-S), and pancreatic beta-cell function (HOMA-B) were investigated in 34 women. Eleven had normal glucose tolerance (NGT) during pregnancy and 23 had GDM (all GAD antibodies-negative). All patients were studied at 28-34 weeks of gestation and 16-24 weeks after delivery (75 g-OGTT). Parameters of interest were determined using commercial test systems. During pregnancy, PAI-1 was not statistically different between NGT and GDM (47+/-25 ng/ml versus 47+/-28 ng/ml, p=0.9). After gestation, 19 (56%) women had NGT (11 of them from previous NGT group) and 15 (44%) had impaired glucose tolerance (IGT) or DM. The IGT (IGT+DM) group had higher PAI-1 (p=0.01), which did not decreased after delivery NGT-NGT before and after delivery (47+/-25 ng/ml versus 6+/-5 ng/ml; p<0.001), GDM-NGT (62+/-36 ng/ml versus 14+/-15 ng/ml; p=0.001) and GDM-IGT (39+/-20 ng/ml versus 27+/-23 ng/ml; p=0.15). PAI-1 levels were positively correlated (p<0.05) to total cholesterol (r(s)=0.37), triglycerides (r(s)=0.48), fasting plasma glucose (r(s)=0.52), 2-h plasma glucose in the OGTT (r(s)=0.58) and were negatively correlated (p<0.05) with HOMA-S (r(s)=-0.42) and HOMA-B (r(s)=-0.38). Fibrinolytic dysfunction is still present in GDM women and is associated with early development of IGT or T2DM. PAI correlated with surrogate markers of MS levels and may identify a group of women at risk for macroangiopathy.

Authors+Show Affiliations

Diabetes Center of Universidade Federal de São Paulo, São Paulo, Brazil.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17544539

Citation

Morimitsu, Lilian K., et al. "Fibrinolytic Dysfunction After Gestation Is Associated to Components of Insulin Resistance and Early Type 2 Diabetes in Latino Women With Previous Gestational Diabetes." Diabetes Research and Clinical Practice, vol. 78, no. 3, 2007, pp. 340-8.
Morimitsu LK, Fusaro AS, Sanchez VH, et al. Fibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetes. Diabetes Res Clin Pract. 2007;78(3):340-8.
Morimitsu, L. K., Fusaro, A. S., Sanchez, V. H., Hagemann, C. C., Bertini, A. M., & Dib, S. A. (2007). Fibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetes. Diabetes Research and Clinical Practice, 78(3), 340-8.
Morimitsu LK, et al. Fibrinolytic Dysfunction After Gestation Is Associated to Components of Insulin Resistance and Early Type 2 Diabetes in Latino Women With Previous Gestational Diabetes. Diabetes Res Clin Pract. 2007;78(3):340-8. PubMed PMID: 17544539.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fibrinolytic dysfunction after gestation is associated to components of insulin resistance and early type 2 diabetes in latino women with previous gestational diabetes. AU - Morimitsu,Lilian K, AU - Fusaro,Annunciata S, AU - Sanchez,Victor H, AU - Hagemann,Cristiane C F, AU - Bertini,Anna Maria, AU - Dib,Sergio A, Y1 - 2007/06/04/ PY - 2007/03/03/received PY - 2007/04/25/accepted PY - 2007/6/5/pubmed PY - 2008/1/17/medline PY - 2007/6/5/entrez SP - 340 EP - 8 JF - Diabetes research and clinical practice JO - Diabetes Res. Clin. Pract. VL - 78 IS - 3 N2 - Among patients with metabolic syndrome (MS), atherosclerosis and abnormal fibrinolytic function are frequently present, mostly owing to an increase in plasminogen activator inhibitor-1(PAI-1). We analyze PAI-1 in pregnant women, both normal and with gestational diabetes (GDM) and postpartum regarding its correlation to MS surrogates. Clinical characteristics, glucose tolerance (100g-OGTT), lipids, PAI-1 antigen, insulin sensitivity (HOMA-S), and pancreatic beta-cell function (HOMA-B) were investigated in 34 women. Eleven had normal glucose tolerance (NGT) during pregnancy and 23 had GDM (all GAD antibodies-negative). All patients were studied at 28-34 weeks of gestation and 16-24 weeks after delivery (75 g-OGTT). Parameters of interest were determined using commercial test systems. During pregnancy, PAI-1 was not statistically different between NGT and GDM (47+/-25 ng/ml versus 47+/-28 ng/ml, p=0.9). After gestation, 19 (56%) women had NGT (11 of them from previous NGT group) and 15 (44%) had impaired glucose tolerance (IGT) or DM. The IGT (IGT+DM) group had higher PAI-1 (p=0.01), which did not decreased after delivery NGT-NGT before and after delivery (47+/-25 ng/ml versus 6+/-5 ng/ml; p<0.001), GDM-NGT (62+/-36 ng/ml versus 14+/-15 ng/ml; p=0.001) and GDM-IGT (39+/-20 ng/ml versus 27+/-23 ng/ml; p=0.15). PAI-1 levels were positively correlated (p<0.05) to total cholesterol (r(s)=0.37), triglycerides (r(s)=0.48), fasting plasma glucose (r(s)=0.52), 2-h plasma glucose in the OGTT (r(s)=0.58) and were negatively correlated (p<0.05) with HOMA-S (r(s)=-0.42) and HOMA-B (r(s)=-0.38). Fibrinolytic dysfunction is still present in GDM women and is associated with early development of IGT or T2DM. PAI correlated with surrogate markers of MS levels and may identify a group of women at risk for macroangiopathy. SN - 1872-8227 UR - https://www.unboundmedicine.com/medline/citation/17544539/Fibrinolytic_dysfunction_after_gestation_is_associated_to_components_of_insulin_resistance_and_early_type_2_diabetes_in_latino_women_with_previous_gestational_diabetes_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0168-8227(07)00302-6 DB - PRIME DP - Unbound Medicine ER -