Components of metabolic syndrome in women after gestational diabetes

The aim of the study was to evaluate the risk of occurrence of metabolic syndrome (MS) in females who suffered from gestational diabetes mellitus (GDM).

495 letters were sent to patients with a history of GDM treated in the Department between 1993-2002. One hundred and fifty-three (30.9%) patients who responded positively formed the study group. Out of them 74 had already been treated for diabetes mellitus, and glucose intolerance was found in 5 subjects. Seventy-four patients had been subjected to a 75 g Oral Glucose Tolerance Test, as well as the control group that consisted of 155 subjects, in whom GDM during pregnancy was excluded. In all patients lipid parameters, blood pressure, height, weight and waist circumference were measured and body mass index (BMI) was calculated. Metabolic syndrome was diagnosed according to the modified NCEP-ATP III criteria from 2005 (3 of 5 had to be fulfilled).

Patients from the study group were older than from the control group (p <0.05), higher was their BMI at the time of the index pregnancy, as well as after the observation time (p <0.0001). Metabolic syndrome was developed in 47 (30.7%) patients of the study group and 8 (5.2%) patients from the control group (p <0.001). The study group presented all components of MS significantly more often than the control group--in both groups, we found respectively: abnormal waist circumference--57% vs. 37.6% (p <0.005), hypertension--18.9% vs. 1.9% (p <0.001), elevated fasting glycemia--79.1% vs. 1.9%, hypertriglyceridemia--21.6% vs. 2.6% (p <0.0001), and decreased concentrations of high-density lipoprotein cholesterol--11.1% vs. 2.6% (p <0.005).

Patients who suffered from GDM are at high risk for carbohydrate disturbances and metabolic syndrome in the following year. Therefore, they should be under continuous medical surveillance that would enable early detection and treatment of the metabolic disturbances.