Laboratory of Endocrinology, Department of Internal Medicine, School of Medicine, Federal University of Minas Gerais, Avenida Alfredo Balena 190, Belo Horizonte, MG 30130-100, Brazil.
Cardiovasc Diabetol. 2012 May 31;11:59. doi: 10.1186/1475-2840-11-59.
Women with previous gestational diabetes mellitus (pGDM) face a higher risk of developing type 2 diabetes and, consequently, a higher cardiovascular risk. This study aimed to compare the carotid intima-media thickness (cIMT) from young women with pGDM to those with metabolic syndrome (MS) and to healthy controls (CG) to verify whether a past history of pGDM could be independently associated with increased cIMT.
This is a cross-sectional study performed in two academic referral centers. Seventy-nine women with pGDM, 30 women with MS, and 60 CG aged between 18 and 47 years were enrolled. They all underwent physical examination and had blood glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol (LDLc), and triglycerides determined. The cIMT was measured by ultrasound in several carotid segments. The primary endpoint was cIMT and clinically relevant parameters included as predictors were: age, systolic blood pressure, waist, BMI, total cholesterol, LDLc, triglycerides, fasting glucose, previous history of GDM as a whole group, previous history of GDM without MS, presence of DM, presence of MS, and parity.
cIMT was significantly higher in pGDM when compared to CG in all sites of measurements (P < 0.05) except for the right common carotid. The pGDM women showed similar cIMT measurements to MS in all sites of measurements, except for the left carotid bifurcation, where it was significantly higher than MS (P < 0.001). In a multivariate analysis which included classical cardiovascular risk factors and was adjusted for confounders, pGDM was shown to be independently associated with increased composite cIMT (P < 0.01). The pGDM without risk factors further showed similar cIMT to MS (P > 0.05) and an increased cIMT when compared to controls (P < 0.05).
Previous GDM was independently associated with increased composite cIMT in this young population, similarly to those with MS and regardless the presence of established cardiovascular risk factors.
患有既往妊娠糖尿病（pGDM）的女性发生 2 型糖尿病的风险较高，因此心血管风险也较高。本研究旨在比较既往有 pGDM 的年轻女性与代谢综合征（MS）患者和健康对照组（CG）的颈动脉内膜中层厚度（cIMT），以验证既往 pGDM 是否与 cIMT 增加独立相关。
这是在两个学术转诊中心进行的横断面研究。共纳入 79 例既往有 pGDM、30 例有 MS 和 60 例 CG 的年龄在 18 至 47 岁的女性。所有女性均接受体格检查，检测血糖、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇（LDLc）和甘油三酯。通过超声测量多个颈动脉节段的 cIMT。主要终点是 cIMT，作为预测指标的临床相关参数包括：年龄、收缩压、腰围、BMI、总胆固醇、LDLc、甘油三酯、空腹血糖、作为整体的既往 GDM 史、无 MS 的既往 GDM 史、DM 的存在、MS 的存在和产次。
与 CG 相比，所有测量部位（除右颈总动脉外）的 pGDM 女性的 cIMT 均显著升高（P<0.05）。除左颈动脉分叉处外，pGDM 女性的 cIMT 与 MS 女性的 cIMT 测量值相似，但显著高于 MS（P<0.001）。在包括经典心血管危险因素并经混杂因素校正的多变量分析中，pGDM 与复合 cIMT 增加独立相关（P<0.01）。无危险因素的 pGDM 进一步显示与 MS 的 cIMT 相似（P>0.05），与对照组相比 cIMT 增加（P<0.05）。
在该年轻人群中，既往 GDM 与复合 cIMT 增加独立相关，与 MS 患者相似，且与已确定的心血管危险因素无关。
