Cardiovascular Risk in Former Gestational Diabetic Women

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The association between diabetes and risk for cardiovascular disease is well established. Women with a history of gestational diabetes mellitus (GDM) are at increased risk of developing type 2 diabetes later in life, and limited but suggestive evidence demonstrates that these women also are more likely to have an unfavorable risk factor profile for coronary heart disease (CHD). The primary aim of this project is to examine the prevalence of risk factors for CHD in women with a history of GDM compared to women without a history of GDM. We will test whether women with a history of GDM: 1) have a higher calculated 10 year relative risk for CHD, 2) have more adverse levels of individual risk factors for CHD, and 3) are more likely to develop CHD risk factors at a younger age, compared to women who did not have GDM, controlling for body size. The secondary aim of this project is to evaluate women's perceptions of their future risk of developing both CHD and diabetes, and whether perception of risk is related to the actual risk. Eighty women with a history of GDM (cases) and 80 women without a history of GDM (controls), who were 30 years of age or older when they gave birth and are now 5 to 10 years postpartum, will be recruited. Cases and controls will be matched for age, ethnicity, and body mass index (BMI) within year of the index pregnancy. Data will be collected during an outpatient admission to the NIH funded General Clinical Research Center. The primary outcomes will be calculated relative risk of CHD, serum lipids, blood pressure, and insulin sensitivity. The secondary outcome will be perception of risk for diabetes and CHD. Body size will be controlled by matching on pre-pregnancy BMI, as well as controlling for current BWI, and central obesity. Demographic and clinical variables, in particular variables known to be related to CHD risk and/or distributed differently among cases and controls, will be considered for inclusion as control variables prior to hypothesis testing. Regression and logistic regression analysis will be used to test for differences between women with and without GDM on the study outcomes. Correlational analysis will be used to determine the relationship between perception of risk and actual risk.