Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus.
Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus.
复制标题
DOI：
10.1371/journal.pone.0136892
复制
发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Ueland T
中科院分区：
文献类型：
--
作者：
Lekva T;Bollerslev J;Norwitz ER;Aukrust P;Henriksen T;Ueland T
妊娠糖尿病（GDM）是老年心血管疾病（CVD）的重要危险因素，但其发病机制尚不清楚。本研究的目的是调查葡萄糖代谢、血脂异常和动脉硬化指数（通过脉搏波速度（PWV）测量），在有和没有GDM病史的女性中，使用旧的WHO和新的IADPSG诊断标准，在指数妊娠后5年。血脂异常和PWV被用作CVD风险的替代标志物。基于人群的前瞻性队列包括来自原始STORK研究的300名女性。所有参与者在怀孕期间都进行了口服葡萄糖耐量试验（OGTT）。5年后，沿着双能X线吸收测定法、血脂分析和PWV分析重复OGTT。根据WHO和IADPSG标准，比较了患有GDM和未患有GDM的女性之间的测量值。我们发现，根据旧的WHO标准，患有GDM的女性在5年时比没有GDM的女性有更高的CVD风险，PWV显著升高，血脂异常更严重（甘油三酯（TG）/HDL胆固醇比值更高）。在调整已知的危险因素后，5年随访时PWV和TG/HDL-C比值升高的最重要预测因素是母亲年龄、BMI、GDM、收缩压和首次妊娠的葡萄糖代谢指数。总之，我们发现，在使用旧的WHO诊断标准时，基于替代标志物PWV和TG/HDL-C比值，在指数妊娠中诊断为GDM的女性在5年随访时发生CVD的风险更高。
Gestational diabetes mellitus (GDM) is a significant risk factor for cardiovascular disease (CVD) in later life, but the mechanism remains unclear. The aim of the study was to investigate indices of glucose metabolism, dyslipidemia, and arterial stiffness (as measured by pulse wave velocity (PWV)), in women with and without a history of GDM, using both the old WHO and new IADPSG diagnostic criteria, at 5 years after the index pregnancy. Dyslipidemia and PWV were used as surrogate markers for CVD risk. The population-based prospective cohort included 300 women from the original STORK study. All participants had an oral glucose tolerance test (OGTT) during pregnancy. Five years later, the OGTT was repeated along with dual-energy x-ray absorptiometry, lipid analysis, and PWV analysis. Measurements were compared between those women who did and did not have GDM based on both the WHO and IADPSG criteria. We found that women with GDM based on the old WHO criteria had higher CVD risk at 5 years than those without GDM, with markedly elevated PWV and more severe dyslipidemia (higher triglycerides (TG)/HDL cholesterol ratio). After adjusting for known risk factors, the most important predictors for elevated PWV and TG/HDL-C ratio at 5-year follow-up were maternal age, BMI, GDM, systolic blood pressure, and indices of glucose metabolism in the index pregnancy. In conclusion, we found a higher risk for CVD, based on the surrogate markers PWV and TG/HDL-C ratio, at 5-year follow-up in women diagnosed with GDM in the index pregnancy when using the old WHO diagnostic criteria.