Subclinical inflammation and vascular dysfunction in women with previous gestational diabetes mellitus
Subclinical inflammation and vascular dysfunction in women with previous gestational diabetes mellitus
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DOI：
10.1210/jc.2004-2494
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发表时间：
2005-07-01
影响因子：
5.8
通讯作者：
Seely, EW
中科院分区：
文献类型：
--
作者：
Heitritter, SM;Solomon, CG;Seely, EW
背景：妊娠糖尿病（GDM）史显著增加发生2型糖尿病的风险，2型糖尿病是心血管疾病（CVD）的独立危险因素。目前尚不清楚既往患有GDM的非糖尿病女性是否也有心血管疾病的风险增加。目的：本研究的目的是比较分娩后至少1年有和没有GDM病史的非糖尿病妇女CVD的生化和血液动力学替代标志物。设计：这是一项单中心横断面研究。环境：本研究在一个学术转诊中心进行。受试者：48名有GDM病史（n = 25）或正常妊娠史（n = 23）的绝经前健康女性在月经周期的卵泡期进行研究。主要结局指标：主要结局指标为：1)与CVD相关的炎症标志物，包括c反应蛋白、IL-6和纤溶酶原激活物抑制剂-1；2)脂肪因子脂联素；3)导管刚度。结果：与正常对照相比，既往患有GDM的女性c -反应蛋白（3.58 +/- 3.86 vs. 0.52 +/- 0.16 mg/l, P < 0.001）、IL-6 （1.81 +/- 1.04 vs. 0.99 +/- 0.52 pg/ml, P = 0.001）、纤溶酶原激活物抑制剂-1 （29.6 +/- 17.6 vs. 16.5 +/- 14.0 ng/ml, P = 0.001）、脂联素水平较低（8.9 +/- 3.9 vs. 15.9 +/- 7.3 mu g/ml, P = 0.001）。既往有GDM的女性也有显著的(P
Context: A history of gestational diabetes (GDM) significantly increases the risk of developing type 2 diabetes, an independent risk factor for cardiovascular disease (CVD). It is not known whether nondiabetic women with prior GDM are also at increased risk of CVD.Objective: The aim of this study was to compare biochemical and hemodynamic surrogate markers of CVD in nondiabetic women with and without a history of GDM who were at least 1 yr post delivery.Design: This was a single center cross-sectional study.Setting: The study was performed in an academic referral center.Subjects: Forty-eight premenopausal healthy women with a history of GDM (n = 25) or a history of normal pregnancy (n = 23) were studied in the follicular phase of the menstrual cycle.Main Outcome Measures: The main outcome measures were: 1) inflammatory markers associated with CVD including C-reactive protein, IL-6, and plasminogen activator inhibitor-1; 2) the adipokine adiponectin; and 3) conduit vessel stiffness.Results: When compared to normal controls, women with prior GDM had higher mean levels of C-reactive protein (3.58 +/- 3.86 vs. 0.52 +/- 0.16 mg/liter; P < 0.001), IL-6 (1.81 +/- 1.04 vs. 0.99 +/- 0.52 pg/ml; P = 0.001), plasminogen activator inhibitor-1 (29.6 +/- 17.6 vs. 16.5 +/- 14.0 ng/ml; P = 0.001), and lower levels of adiponectin (8.9 +/- 3.9 vs. 15.9 +/- 7.3 mu g/ml; P = 0.001). Women with prior GDM also had significantly (P