Assessment of arterial stiffness in women with gestational diabetes

Bulzico, Daniel; Zajdenverg, Lenita; Cabizuca, Carolina A.; Oliveira, José Egídio Paulo de; Salles, Gil F.

doi:10.1111/j.1464-5491.2011.03471.x

Cited by 13 publications

(14 citation statements)

References 28 publications

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“…Endothelial dysfunction has been associated with a higher risk for cardiovascular disease in patients with diabetes, showing that the hyperglycaemic environment promotes micro-and macrovascular dysfunction [7,8]. Although GDM is considered a temporary state as it is alleviated by delivery, some studies have suggested that alterations in endothelial responsiveness occur [9], whereas others have suggested that the duration of exposure to hyperglycaemia is insufficient to induce vascular dysfunction [10,11].…”

Section: Introductionmentioning

confidence: 99%

Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors

et al. 2016

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Aims/hypothesis Gestational diabetes mellitus (GDM) is a risk factor for the development of endothelial dysfunction and cardiovascular disease. However, in vivo microvascular endothelial function in GDM has not been investigated. This study aimed to examine, using near-infrared spectroscopy (NIRS), whether: (1) there are differences in microvascular reactivity and skeletal muscle oxygen consumption (mVat rest and during exercise between GDM and uncomplicated pregnancies; and (2) ) and blunted hyperaemia (ΔTSI 6.8 ± 2.9 vs 9.5 ± 3.4) compared with controls (p < 0.01). Despite similar handgrip strength in the GDM and control groups (29.1 ± 8.1 vs 26.2 ± 10.4 kg, respectively), during repeated forearm contractions, women with GDM presented a blunted TSI response (6.5 ± 3.9 vs 19.2 ± 10.9; p < 0.01) and a reduced capacity to maintain the predetermined handgrip (23.4 ± 2.9 vs 27.4 ± 3.8%, p < 0.05). NIRS indices correlated with PWV, 24 h BP and blood glucose concentration earlier in pregnancy (r = 0.40-0.60; p < 0.05). Conclusions/interpretation Women with GDM exhibited a characteristic blunted TSI curve, showing alterations in muscle oxygenation and microvascular responsiveness compared with women with uncomplicated pregnancies. These alterations were manifested during exercise and possibly contribute to the reduced exercise tolerance in GDM. NIRS indices correlated with macrovascular indices (arterial stiffness) and 24 h BP.

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Section: Introductionmentioning

confidence: 99%

Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors

et al. 2016

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“…Firstly, all aortic stiffness parameters (aortic stiffness index, distensibility, and aortic strain) exhibited significant differences in the GDM patient group compared to the control group. There are very few studies in the literature addressing this topic (18,19), and none is revealing any statistical significance between these two groups. Secondly, a significant improvement was observed in aortic stiffness in normoglycemic postpartum GDM group, but there was no significant difference in hyperglycemic group.…”

Section: Discussionmentioning

confidence: 91%

“…Blood pressure is the best-known determinant of arterial stiffness, which might affect the results in the GDM group. Bulzico et al (18) did not find any significant difference in arterial stiffness between the GDM and control groups in a study conducted on a more homogeneous control group. They argued that time of exposure to hyperglycemia might be more important for arterial stiffness.…”

Section: Discussionmentioning

confidence: 97%

“…In this study, a correlation was also found between postprandial glucose levels and arterial stiffness. Bulzico et al (18) did not find a significant relation between postprandial glucose and arterial stiffness. The non-significant effect of current GDM treatment on arterial stiffness and the correlation between postprandial glucose level and arterial stiffness may indicate that the effect of hyperglycemia on arterial stiffness is highly important.…”

Section: Discussionmentioning

confidence: 97%

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Effect of Human Gestational Diabetes Mellitus on Arterial Stiffness

İnci¹

2014

Acta Endo (Buc)

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Background. The present study aims to evaluate the parameters for aortic stiffness by comparing gestational diabetes mellitus (GDM) with a healthy control group via transthoracic echocardiography.Methods. This was a cross-sectional study involving monitoring of 62 pregnant women (33 with GDM and 29 with uncomplicated pregnancy as controls) during the third trimester. The aortic strain, aortic distensibility, and aortic stiffness values were measured via transthoracic echocardiography. Measurements of GDM group were repeated after 6 months.Results. Blood pressure levels, heart rate, and basic echocardiography were similar in both groups, but BMI was significantly higher in the GDM group (p <0.001). Whereas, aortic strain and distensibility were significantly lower in the GDM group (p <0.001). Aortic stiffness index was significantly higher in the GDM group (p <0.001). Aortic stiffness parameters did not exhibit any significant difference between the insulin-receiving GDM group and the diet-controlled GDM group. Postprandial glucose levels were correlated positively with the aortic stiffness index (p=0.04) andnegatively with the level of aortic strain (p<0.01) and distensibility (p=0.03). The aortic stiffness in normoglycemic postpartum group at 6 th month showed a significant improvement (p<0.001); but not in hyperglycemic postpartum group.Conclusion. Arterial stiffness was increased in women with GDM compared to the control group. A correlation between postprandial glucose and arterial stiffness was found. The aortic stiffness can be affected irreversibly from increased clinical and subclinical levels of glucose in postpartum period.

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“…37 Contrary to this results, Bulzico et al and Salmi et al, investigating arterial stiffness in gestational diabetes, found that their pregnant diabetic women, do not have significant increased arterial stiffness. 38,39 But in their study, patients with any previous glucose impairment were excluded. In other words, their study population was exposed to hyperglycemia only during their present pregnancy contrary to our pregnant diabetic women whose majority of them have history of gestational diabetes in previous pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Insulin resistance and arterial stiffness: impact of gestational diabetes on pulse wave velocity

Seck¹,

Agne

Fall³

et al. 2018

Int J Res Med Sci

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Background: Gestational diabetes is an intolerance of glucose with the first appearance during the pregnancy. This hyperglycaemia status, because of the pre-existing insulin-resistance, constitute a favourable land of arterial stiffness. The aim of this study is to determine the impact of non obese gestational diabetes on arterial stiffness by measuring the pulse wave velocity (PWV).Methods: We recruited 60 pregnant women aged from 20 to 35 years old. They were between twentieth four and thirtieth five weeks of gestational age. Subjects were divided into two groups: the first group (G1), considered as control group, included 25 normoglycemic pregnant subjects without any history of illness or risk factors of gestational diabetes; the second group (G2) included 35 women with Gestational Diabetes Mellitus (GDM). All pregnant women had not history of smoking, were not taking decoction or medicine, which could disturb pregnancy evolution. Anthropo-physiological and biochemical parameters studied, were: age, body mass index (BMI), blood pressure (BP), triglyceride, cholesterol and HOMA-IR index. The PWV between finger and toe (PWVft) was measured by pOpmètre®.Results: The two groups are matched by age (G1:28±4ans; G2:29±3ans) and BMI (G1:25.6±1.27; G2:26.9±1.3). Blood pressure (BP) values are in normal interval (systolic BP: [110-132mmHg]; diastolic BP: [63-87mmHg]; mean BP: [79-103mmHg]). Total cholesterol (G1:0.95±0.08;G2:2.4±0.7; p˂0.0001), HDL cholesterol (G1:0.44±0.02; G2:0.76±0.2; p˂0.0001, LDL cholesterol (G1:0.40±0.05; G2:1.3±0.5; p˂0.0001), triglyceride (G1:0.57±0.45; G2:1.6±0.4;p˂0.0001), HOMA.IR (G1:1.31±1.05; G2:7.4±1.07; p˂0.01), PWVft (G1:5.99±1.23; G2:10.3±1.9; p˂0.0001) are significantly higher in diabetic group. PWVft is positively correlate to HOMA-IR index, total cholesterol, LDL cholesterol and triglycerides (r=0.3348, p=0.032; r=0.5275, p˂0.0001; r=0.4855,p˂0.0001; r=0.5581, p˂0.0001respectively).Conclusions: Gestational diabetes might induce an increase of pulse wave velocity expressing increment of arterial stiffness. This last constitute an early underlying cardiovascular risk.

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Assessment of arterial stiffness in women with gestational diabetes

Cited by 13 publications

References 28 publications

Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors

Impairments in microvascular function and skeletal muscle oxygenation in women with gestational diabetes mellitus: links to cardiovascular disease risk factors

Effect of Human Gestational Diabetes Mellitus on Arterial Stiffness

Insulin resistance and arterial stiffness: impact of gestational diabetes on pulse wave velocity

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