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Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes.
Acta Obstet Gynecol Scand. 2012 Feb; 91(2):182-8.AO

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+Show Affiliations

Department of Gastroenterology, Angiology and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum, Dr J. Biziel University Hospital, Bydgoszcz, Poland. alinasokup@o2.plNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

21954994

Citation

Sokup, Alina, et al. "Triglycerides as an Early Pathophysiological Marker of Endothelial Dysfunction in Nondiabetic Women With a Previous History of Gestational Diabetes." Acta Obstetricia Et Gynecologica Scandinavica, vol. 91, no. 2, 2012, pp. 182-8.
Sokup A, Góralczyk B, Góralczyk K, et al. Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes. Acta Obstet Gynecol Scand. 2012;91(2):182-8.
Sokup, A., Góralczyk, B., Góralczyk, K., & Rość, D. (2012). Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes. Acta Obstetricia Et Gynecologica Scandinavica, 91(2), 182-8. https://doi.org/10.1111/j.1600-0412.2011.01289.x
Sokup A, et al. Triglycerides as an Early Pathophysiological Marker of Endothelial Dysfunction in Nondiabetic Women With a Previous History of Gestational Diabetes. Acta Obstet Gynecol Scand. 2012;91(2):182-8. PubMed PMID: 21954994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes. AU - Sokup,Alina, AU - Góralczyk,Barbara, AU - Góralczyk,Krzysztof, AU - Rość,Danuta, PY - 2011/9/30/entrez PY - 2011/10/1/pubmed PY - 2012/3/23/medline SP - 182 EP - 8 JF - Acta obstetricia et gynecologica Scandinavica JO - Acta Obstet Gynecol Scand VL - 91 IS - 2 N2 - 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. SN - 1600-0412 UR - https://www.unboundmedicine.com/medline/citation/21954994/Triglycerides_as_an_early_pathophysiological_marker_of_endothelial_dysfunction_in_nondiabetic_women_with_a_previous_history_of_gestational_diabetes_ L2 - https://doi.org/10.1111/j.1600-0412.2011.01289.x DB - PRIME DP - Unbound Medicine ER -