Internal Medicine Department, Medical School and University Hospital Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil.
Diabet Med. 2012 Feb;29(2):227-31. doi: 10.1111/j.1464-5491.2011.03471.x.
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.
妊娠糖尿病可能先于 2 型糖尿病发生,并且可能与心血管疾病有关。脉搏波速度测量是评估动脉僵硬度的金标准方法,动脉僵硬度是一种临床前心血管风险标志物。然而,主动脉僵硬度与妊娠糖尿病之间的关系尚不清楚。本研究旨在比较患有妊娠糖尿病的女性与健康孕妇的对照组,评估其主动脉脉搏波速度。
本病例对照研究纳入了 24 名患有妊娠糖尿病的女性和 27 名匹配的对照组受试者。获取了临床、人口统计学和实验室变量,并测量了主动脉脉搏波速度。
两组的年龄、妊娠周数、体重指数、种族、吸烟状况和血压水平相似。患有妊娠糖尿病的女性与对照组的主动脉脉搏波速度相当:7.2±0.9 与 7.3±1.2m/s(P=0.79)。根据脉搏波速度(7.3m/s)的中位数进行分类时,年龄(P<0.001)、舒张压(P=0.03)和心率(P=0.02)与动脉僵硬度增加相关。在妊娠糖尿病组中,脉搏波速度较高(高于中位数)的患者餐后 1 小时血糖较高(6.5±0.8 与 7.1±1.3mmol/L,P=0.22),且血糖控制良好的患者比例较低(38.5%与 72.7%,P=0.09)。
尽管妊娠糖尿病可能是心血管疾病的危险因素,但患有妊娠糖尿病的女性的主动脉僵硬度并不高于健康孕妇。暴露于高血糖的时间可能不足以增加妊娠糖尿病女性的中心动脉僵硬度。