Diabetes Metab J.  2011 Oct;35(5):497-503. 10.4093/dmj.2011.35.5.497.

Carotid Intimal-Medial Thickness Is Not Increased in Women with Previous Gestational Diabetes Mellitus

• Ku YH
• Choi SH
• Lim S
• Cho YM
• Park YJ
• Park KS
• Kim SY
• Jang HC

• KMID: 1857505
• DOI: http://doi.org/10.4093/dmj.2011.35.5.497

Abstract

BACKGROUND
Gestational diabetes mellitus (GDM) is known to increase the risk of cardiovascular diseases. Measuring the carotid artery intimal-medial thickness (CIMT) is a non-invasive technique used to evaluate early atherosclerosis and to predict future cardiovascular diseases. We examined the association between CIMT and cardiovascular risk factors in young Korean women with previous GDM.
METHODS
One hundred one women with previous GDM and 19 women who had normal pregnancies (NP) were recruited between 1999 and 2002. At one year postpartum, CIMT was measured using high-resolution B-mode ultrasonography, and oral glucose tolerance tests were performed. Fasting glucose, glycated hemoglobin A1c (HbA1c), insulin levels and lipid profiles were also measured. CIMTs in the GDM and NP groups were compared, and the associations between CIMT and cardiovascular risk factors were analyzed in the GDM group.
RESULTS
CIMT results of the GDM group were not significantly different from those of the NP group (GDM, 0.435+/-0.054 mm; NP, 0.460+/-0.046 mm; P=0.069). In the GDM group, a higher HbA1c was associated with an increase in CIMT after age adjustment (P=0.011). CIMT results in the group with HbA1c >6.0% were higher than those of the normal HbA1c (HbA1c < or =6.0%) (P=0.010). Nine of the patients who are type 2 diabetes mellitus converters within one year postpartum but showed no significant difference in CIMT results compared to NP group.
CONCLUSION
Higher HbA1c is associated with an increase in CIMT in women with previous GDM. However, CIMT at one year postpartum was not increased in these women compared to that in NP women.

Keyword

Cardiovascular diseases; Carotid atherosclerosis; Diabetes, gestational; Diabetes mellitus, type 2

MeSH Terms

Atherosclerosis
Cardiovascular Diseases
Carotid Arteries
Carotid Artery Diseases
Diabetes Mellitus, Type 2
Diabetes, Gestational
Fasting
Female
Glucose
Glucose Tolerance Test
Hemoglobins
Humans
Insulin
Postpartum Period
Pregnancy
Risk Factors
Glucose
Hemoglobins
Insulin

Figure

• 

  Fig. 1 Difference in carotid artery intimal-medial thickness (CIMT) between normal and increased HbA1c groups in women with a history of gestational diabetes mellitus. In the women with a history of gestational diabetes mellitus, the CIMT of those in the high HbA1c group (HbA1c >6.0%) was higher than that of those women who had a normal HbA1c (HbA1c ≤6.0%) (0.448±0.057 mm vs. 0.420±0.047 mm, P=0.010).

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