Should we consider gestational diabetes a vascular risk factor?

Area of Science:

• Cardiovascular Research
• Endocrinology
• Women's Health

Background:

• Previous gestational diabetes mellitus (pGDM) is linked to vascular endothelial dysfunction and inflammation.
• Data on long-term vascular changes post-pGDM remain limited and contrasting.

Purpose of the Study:

• To evaluate intimal medial thickness (IMT) and inflammatory/endothelial dysfunction markers in women with pGDM compared to controls, 6.5 years after delivery.
• To assess the association between these markers and pGDM, considering current BMI and metabolic status.

Main Methods:

• Cross-sectional study comparing 82 non-pregnant women with pGDM and 113 controls.
• Measurements included intimal medial thickness (IMT), C-reactive protein (CRP), interleukin-6 (IL-6), E-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular adhesion molecule-1 (VCAM-1).
• Regression analysis adjusted for BMI, waist circumference, blood pressure, and glucose.

Main Results:

• Women with pGDM exhibited significantly higher E-selectin, ICAM-1, and IMT compared to controls, irrespective of current BMI or metabolic abnormalities.
• IMT was significantly associated with pGDM after adjusting for covariates.
• E-selectin, ICAM-1, IL-6, and hs-CRP were significantly associated with IMT in pGDM women.

Conclusions:

• Women with a history of pGDM demonstrate persistent endothelial dysfunction and increased IMT years post-delivery.
• These findings suggest an elevated future cardiovascular risk in women with pGDM, even in the absence of current metabolic abnormalities.