Review of gestational diabetes mellitus effects on vascular structure and function

Abstract

Vascular dysfunction has been described in women with a history of gestational diabetes mellitus. Furthermore, previous gestational diabetes mellitus increases the risk of developing Type 2 diabetes mellitus, a risk factor for cardiovascular disease. Factors contributing to vascular changes remain uncertain. The aim of this review was to summarize vascular structure and function changes found to occur in women with previous gestational diabetes mellitus and to identify factors that contribute to vascular dysfunction. A systematic search of electronic databases yielded 15 publications from 1998 to March 2014 that met the inclusion criteria. Our review confirmed that previous gestational diabetes mellitus contributes to vascular dysfunction, and the most consistent risk factor associated with previous gestational diabetes mellitus and vascular dysfunction was elevated body mass index. Heterogeneity existed across studies in determining the relationship of glycaemic levels and insulin resistance to vascular dysfunction.

Early Postpartum Lipid Profile in Women with and Without Gestational Diabetes Mellitus: Results of a Prospective Cohort Study

“…Consistent with our results, total cholesterol level and triglycerides in women with history of GDM were elevated in postpartum compared with controls (7,26,27). Increased low-density lipoprotein (LDL) was reported in Caucasian women 6 years after GDM pregnancy (28, 29), Retnakaran et al reported significant differences in total cholesterol, LDL, triglycerides, total cholesterol to HDL ratio with glucose status in pregnancy at 3 months postpartum in Canadian women (30).…”

“…Some previous studies reported similar or lower LDL-C in none-obese women with GDM, while obese women with GDM had higher level of this component compared with controls. Obese GDM-exposed women had lower HDL-C, while there were no significant differences between HDL-C level in non-obese women with GDM and controls (7). Elevated triglyceride in combination raised LDL-cholesterol, and low HDL-C are types of dyslipidemia associated with obesity.…”

Roles of MicroRNA across Prenatal and Postnatal Periods

“…GD, a glucose intolerance first recognized during pregnancy, is an independent risk factor of disease in both offspring and mother [60,61]. The hyperglycemia occurring during pregnancy induces long-term phenotypic alterations in fetal endothelial cells, changes in miR-101 expression levels, as well as in those of Enhancer of Zester Homolog 2 (EZH2), its target [24].…”

Is fibroblast growth factor 23 a new cardiovascular risk marker in gestational diabetes?

“…The decrease in the level of 1,25(OH) 2 D 3 , reduction in expression of soluble Klotho, activation of the reninangiotensin system, increase in sodium retention in the kidneys, increase in inflammatory markers, and hypophosphatemia could be explanations for the effect of FGF23 on the cardiovascular system. GDM contributes to vascular dysfunction, as recently reported in a metaanalysis (34). The hypothesis of whether FGF23 levels are high in patients with GDM, which brings increased risk of cardiovascular disease, was tested in our study.…”