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Hidden metabolic disturbances in women with normal glucose tolerance five years after gestational diabetes.

Winhofer Y, Tura A, Thomas A, Prikoszovich T, Winzer C, Pacini G, Luger A, Kautzky-Willer A - Int J Endocrinol (2015)

Bottom Line: Methods. 45 pGDM with NGT were compared to 18 women without a history of GDM (CON), matched for age (37.0 ± 4.1 versus 35.2 ± 5.3, P = ns) and BMI (24.3 ± 3.1 versus 23.3 ± 3.3, P = ns).Five years postpartum, pGDM had increased glucose concentrations during the OGTT (AUC: 1.12 ± 0.15 versus 1.0 ± 0.12 mol/L ∗ min, P = 0.003) and insulin sensitivity was decreased compared to CON (OGIS: 467.2 ± 64.1 versus 510.6 ± 53.1 mL/min ∗ m(2), P = 0.01). pGDM had lower adiponectin (8.1 ± 2.6 versus 12.6 ± 5.3, P < 0.008) but increased waist circumference and CRP compared to CON.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.

ABSTRACT
Background. The study aimed to assess whether women with prior gestational diabetes (pGDM), despite maintenance of normal glucose tolerance (NGT) five years after delivery, display metabolic disturbances compared to healthy controls. Methods. 45 pGDM with NGT were compared to 18 women without a history of GDM (CON), matched for age (37.0 ± 4.1 versus 35.2 ± 5.3, P = ns) and BMI (24.3 ± 3.1 versus 23.3 ± 3.3, P = ns). Metabolic parameters were derived from oral and intravenous glucose tolerance tests; furthermore lipid profile, C-reactive protein (CRP), adiponectin, leptin, and glucagon were assessed. Results. Five years postpartum, pGDM had increased glucose concentrations during the OGTT (AUC: 1.12 ± 0.15 versus 1.0 ± 0.12 mol/L ∗ min, P = 0.003) and insulin sensitivity was decreased compared to CON (OGIS: 467.2 ± 64.1 versus 510.6 ± 53.1 mL/min ∗ m(2), P = 0.01). pGDM had lower adiponectin (8.1 ± 2.6 versus 12.6 ± 5.3, P < 0.008) but increased waist circumference and CRP compared to CON. Conclusions. Despite diagnosis of normal glucose tolerance, pGDM are characterized by hyperglycemia and insulin resistance compared to healthy controls, accompanied by decreased adiponectin and increased CRP concentrations, thus linking metabolic disturbances to an increased cardiovascular risk in pGDM.

No MeSH data available.


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Higher glucose concentrations at fasting and stimulated conditions in pGDM compared to CON.
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fig1: Higher glucose concentrations at fasting and stimulated conditions in pGDM compared to CON.

Mentions: Five years after the index pregnancy, pGDM—despite normal glucose tolerance—had significantly higher levels of plasma glucose at fasting as well as 60 minutes of the OGTT compared to CON; in line, the AUC of glucose was significantly increased in pGDM compared to CON (Figure 1). Insulin sensitivity, derived by OGIS, was decreased in pGDM compared to CON (Figure 2(a)). Furthermore, adiponectin was lower in pGDM (Figure 2(b)), while blood pressure, leptin, glucagon, TSH, and lipid profile did not differ between the groups. pGDM had significantly higher waist circumference (Figure 2(c)) as well as CRP concentrations, (Figure 2(d)). Normal body weight, defined as BMI < 25 kg/m2, was found in 30 out of 45 pGDM (=66.7%) and in 14 out of 18 CON (=77.8%). Insulin sensitivity (OGIS) was negatively correlated with BMI and body weight in the whole study group (BMI: R = −0.3, P = 0.01; body weight: R = −0.3, P = 0.02).


Hidden metabolic disturbances in women with normal glucose tolerance five years after gestational diabetes.

Winhofer Y, Tura A, Thomas A, Prikoszovich T, Winzer C, Pacini G, Luger A, Kautzky-Willer A - Int J Endocrinol (2015)

Higher glucose concentrations at fasting and stimulated conditions in pGDM compared to CON.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4385652&req=5

fig1: Higher glucose concentrations at fasting and stimulated conditions in pGDM compared to CON.
Mentions: Five years after the index pregnancy, pGDM—despite normal glucose tolerance—had significantly higher levels of plasma glucose at fasting as well as 60 minutes of the OGTT compared to CON; in line, the AUC of glucose was significantly increased in pGDM compared to CON (Figure 1). Insulin sensitivity, derived by OGIS, was decreased in pGDM compared to CON (Figure 2(a)). Furthermore, adiponectin was lower in pGDM (Figure 2(b)), while blood pressure, leptin, glucagon, TSH, and lipid profile did not differ between the groups. pGDM had significantly higher waist circumference (Figure 2(c)) as well as CRP concentrations, (Figure 2(d)). Normal body weight, defined as BMI < 25 kg/m2, was found in 30 out of 45 pGDM (=66.7%) and in 14 out of 18 CON (=77.8%). Insulin sensitivity (OGIS) was negatively correlated with BMI and body weight in the whole study group (BMI: R = −0.3, P = 0.01; body weight: R = −0.3, P = 0.02).

Bottom Line: Methods. 45 pGDM with NGT were compared to 18 women without a history of GDM (CON), matched for age (37.0 ± 4.1 versus 35.2 ± 5.3, P = ns) and BMI (24.3 ± 3.1 versus 23.3 ± 3.3, P = ns).Five years postpartum, pGDM had increased glucose concentrations during the OGTT (AUC: 1.12 ± 0.15 versus 1.0 ± 0.12 mol/L ∗ min, P = 0.003) and insulin sensitivity was decreased compared to CON (OGIS: 467.2 ± 64.1 versus 510.6 ± 53.1 mL/min ∗ m(2), P = 0.01). pGDM had lower adiponectin (8.1 ± 2.6 versus 12.6 ± 5.3, P < 0.008) but increased waist circumference and CRP compared to CON.Conclusions.

View Article: PubMed Central - PubMed

Affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.

ABSTRACT
Background. The study aimed to assess whether women with prior gestational diabetes (pGDM), despite maintenance of normal glucose tolerance (NGT) five years after delivery, display metabolic disturbances compared to healthy controls. Methods. 45 pGDM with NGT were compared to 18 women without a history of GDM (CON), matched for age (37.0 ± 4.1 versus 35.2 ± 5.3, P = ns) and BMI (24.3 ± 3.1 versus 23.3 ± 3.3, P = ns). Metabolic parameters were derived from oral and intravenous glucose tolerance tests; furthermore lipid profile, C-reactive protein (CRP), adiponectin, leptin, and glucagon were assessed. Results. Five years postpartum, pGDM had increased glucose concentrations during the OGTT (AUC: 1.12 ± 0.15 versus 1.0 ± 0.12 mol/L ∗ min, P = 0.003) and insulin sensitivity was decreased compared to CON (OGIS: 467.2 ± 64.1 versus 510.6 ± 53.1 mL/min ∗ m(2), P = 0.01). pGDM had lower adiponectin (8.1 ± 2.6 versus 12.6 ± 5.3, P < 0.008) but increased waist circumference and CRP compared to CON. Conclusions. Despite diagnosis of normal glucose tolerance, pGDM are characterized by hyperglycemia and insulin resistance compared to healthy controls, accompanied by decreased adiponectin and increased CRP concentrations, thus linking metabolic disturbances to an increased cardiovascular risk in pGDM.

No MeSH data available.


Related in: MedlinePlus