J Korean Diabetes.  2014 Jun;15(2):116-123. 10.4093/jkd.2014.15.2.116.

Risk Factors for Progression to Postpartum Diabetes Mellitus and Perinatal Complications in Women with Gestational Diabetes Mellitus

• Kim SJ
• Chun H
• Jang EH
• Lee JS
• Kim M
• Baek KH
• Song KH
• Kwon HS

• KMID: 2173904
• DOI: http://doi.org/10.4093/jkd.2014.15.2.116

Abstract

BACKGROUND
Gestational diabetes mellitus (GDM) is a hyperglycemic condition caused by increased insulin resistance and impaired insulin secretion during pregnancy. It is known to be temporary, but it can cause perinatal complications in the mother and baby. Additionally, it may progress to type 2 diabetes mellitus (T2DM). In the present study, we evaluated the risk factors for complications and progression to T2DM in patients with GDM.
METHODS
The study included 130 pregnant women who were diagnosed with GDM at gestational weeks 24-28 in 2011. Body mass index and the levels of glucose, total cholesterol, lipoproteins, and coagulation factors (von Willebrand factor and plasminogen activator inhibitor-1) were assessed in all patients.
RESULTS
The level of high-density lipoprotein (HDL) was significantly lower and the triglyceride/HDL ratio and coagulation factor levels were significantly higher in the group of patients with perinatal complications compared to those in the group of patients without complications. After delivery, the level of HDL was lower and the value of homeostasis model assessment of insulin resistance (HOMA-IR) was higher in women with impaired glucose metabolism compared to those in women with normal glucose metabolism. In logistic regression analysis, perinatal complications were independently associated with HDL and PAI-1 levels (OR = 0.929 and 1.101, respectively).
CONCLUSION
The findings of our study show that the levels of HDL and coagulation factors are notable risk factors of perinatal complications. Additionally, we showed that lower HDL level may influence the progression to T2DM. Large-scale population studies are needed to verify our findings.

Keyword

Gestational diabetes mellitus; Risk factors; High-density lipoproteins; von Willebrand factor; Plasminogen activator inhibitor 1

MeSH Terms

Blood Coagulation Factors
Body Mass Index
Cholesterol
Diabetes Mellitus*
Diabetes Mellitus, Type 2
Diabetes, Gestational*
Female
Glucose
Homeostasis
Humans
Insulin
Insulin Resistance
Lipoproteins
Lipoproteins, HDL
Logistic Models
Metabolism
Mothers
Plasminogen Activator Inhibitor 1
Plasminogen Activators
Postpartum Period*
Pregnancy
Pregnant Women
Risk Factors*
von Willebrand Factor
Blood Coagulation Factors
Cholesterol
Glucose
Insulin
Lipoproteins
Lipoproteins, HDL
Plasminogen Activator Inhibitor 1
Plasminogen Activators
von Willebrand Factor

Reference

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