妊娠期糖尿病女性亚临床动脉粥样硬化的早期发病

Early onset of subclinical atherosclerosis in women with gestational diabetes mellitus.

作者信息

Tarim E, Yigit F, Kilicdag E, Bagis T, Demircan S, Simsek E, Haydardedeoglu B, Yanik F

机构信息

Department of Obstetrics and Gynecology, Baskent University School of Medicine, Adana, Turkey.

出版信息

Ultrasound Obstet Gynecol. 2006 Feb;27(2):177-82. doi: 10.1002/uog.2687.

DOI:10.1002/uog.2687

PMID:16435313

Abstract

OBJECTIVE

Common carotid artery intima-media thickness (CIMT) is a non-invasively assessed marker of subclinical atherosclerosis. Our aim in this study was to investigate CIMT in women with gestational diabetes mellitus (GDM).

METHODS

Thirty women with GDM and 40 unaffected women (as a control group) were included in the study. Blood samples were drawn from each woman in the morning after they had fasted for at least 8 h, and levels of fasting glucose, insulin, homocysteine, total cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol and very low-density lipoprotein (VLDL) cholesterol were measured, along with the CIMT in the two groups.

RESULTS

The mean triglyceride (P = 0.016) and VLDL cholesterol (P = 0.011) levels in the GDM group were significantly higher than those in the unaffected women. There were no significant differences between the groups with respect to plasma levels of total cholesterol, HDL cholesterol, LDL cholesterol and insulin. The mean homocysteine (P = 0.027) and fasting glucose (P = 0.019) levels in women with GDM were significantly higher than those in the control group. Patients with GDM had significantly higher CIMT than did the unaffected women (0.582 +/- 0.066 mm vs. 0.543 +/- 0.049 mm, P = 0.006). CIMT correlated positively with maternal age (r = 0.316, P = 0.008), body mass index (BMI) at the time of a 50-g oral glucose load test (r = 0.414, P = 0.001) and homocysteine levels (r = 0.332, P = 0.008), and fasting glucose (r = 0.265, P = 0.031) and 1-h glucose value (r = 0.410, P = 0.001) at the time of the oral glucose tolerance test. There was a positive correlation between the presence of GDM and CIMT (r = 0.372, P = 0.001). However, stepwise multiple regression analysis showed that GDM/no GDM (95% CI +0.012 to +0.076, P = 0.008) and BMI at the time of the 50-g test (95% CI +0.001 to +0.009, P = 0.011) were independent parameters related to CIMT.

CONCLUSION

Women with GDM have increased CIMT compared with unaffected women.

摘要

目的

颈总动脉内膜中层厚度（CIMT）是一种用于亚临床动脉粥样硬化的无创评估指标。本研究的目的是调查妊娠期糖尿病（GDM）女性的CIMT。

方法

本研究纳入了30例GDM女性和40例未受影响的女性（作为对照组）。在每位女性至少禁食8小时后的早晨采集血样，测量空腹血糖、胰岛素、同型半胱氨酸、总胆固醇、高密度脂蛋白（HDL）胆固醇、甘油三酯、低密度脂蛋白（LDL）胆固醇和极低密度脂蛋白（VLDL）胆固醇水平，以及两组的CIMT。

结果

GDM组的平均甘油三酯（P = 0.016）和VLDL胆固醇（P = 0.011）水平显著高于未受影响的女性。两组在总胆固醇、HDL胆固醇、LDL胆固醇和胰岛素的血浆水平方面无显著差异。GDM女性的平均同型半胱氨酸（P = 0.027）和空腹血糖（P = 0.019）水平显著高于对照组。GDM患者的CIMT显著高于未受影响的女性（0.582±0.066 mm对0.543±0.049 mm，P = 0.006）。CIMT与母亲年龄（r = 0.316，P = 0.008）、50克口服葡萄糖负荷试验时的体重指数（BMI）（r = 0.414，P = 0.001）、同型半胱氨酸水平（r = 0.332，P = 0.008）、空腹血糖（r = 0.265，P = 0.031）以及口服葡萄糖耐量试验时的1小时血糖值（r = 0.410，P = 0.001）呈正相关。GDM的存在与CIMT之间存在正相关（r = 0.372，P = 0.001）。然而，逐步多元回归分析显示，GDM/无GDM（95%CI +0.012至+0.076，P = 0.008）和50克试验时的BMI（95%CI +0.001至+0.009，P = 0.011）是与CIMT相关的独立参数。