Effect of Human Gestational Diabetes Mellitus on Arterial Stiffness

Abstract

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.

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

“…Our results corroborate previous outcomes finding that pregnant women with GDM and type 2 diabetes exhibit increasing of maternal arterial stiffness. [28][29][30][31][32][33] Furthermore, several studies have reported that alteration of arterial stiffness occur in subjects with impaired glucose tolerance, polycystic ovaries, and newly diagnosed type 2 diabetes. [34][35][36] Moreover, in our study, we found a correlation between PWVft and insulinresistance state of GDM women, as assessed by the level of HOMA-IR index.…”