Assessment of arterial stiffness in women with gestational diabetes

Gestational diabetes mellitus may precede development of Type 2 diabetes and may be related to cardiovascular disease. Pulse wave velocity measurement is the gold-standard method to evaluate arterial stiffness, a preclinical cardiovascular risk marker. However, the relationship between aortic stiffness and gestational diabetes is unclear. The aim of this study was to evaluate aortic pulse wave velocity in women with gestational diabetes in comparison with a matched control group of healthy pregnant women.

This case-control study included 24 women with gestational diabetes and 27 matched control subjects. Clinical, demographic and laboratory variables were obtained and aortic pulse wave velocity were measured.

Both groups had similar age, gestational age, BMI, ethnicity, smoking status and blood pressure levels. Women with gestational diabetes had aortic pulse wave velocity comparable with control subjects: 7.2 ± 0.9 vs. 7.3 ± 1.2 m/s (P = 0.79). When categorized according to the median value of pulse wave velocity (7.3 m/s), age (P < 0.001), diastolic blood pressure (P = 0.03) and heart rate (P = 0.02) were associated with increased arterial stiffness. In the group with gestational diabetes, there was a non-significant trend towards higher 1-h postprandial glycaemia in patients with higher (above the median) pulse wave velocity (6.5 ± 0.8 vs. 7.1 ± 1.3 mmol/l, P = 0.22) and a lower prevalence of patients with good glycaemic control (38.5 vs. 72.7%, P = 0.09).

Although gestational diabetes may be a risk factor for development of cardiovascular disease, women with gestational diabetes do not have higher aortic stiffness than healthy pregnant women. Time of exposure to hyperglycaemia may have been insufficient to increase central arterial stiffness in women with gestational diabetes.