The temporal trend of vascular function in women with gestational diabetes

Garg, Priyanka; Badhwar, Smriti; Jaryal, Ashok Kumar; Kachhawa, Garima; Deepak, K K; Kriplani, Alka

doi:10.1177/1358863x16678479

Cited by 8 publications

(10 citation statements)

References 31 publications

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“…The electronic search from the databases yielded 10,626 potential studies of which 10,609 were excluded as they were duplicates or a review of the title or abstract that did not meet the inclusion criteria, leaving 17 studies for full-text review. After the full manuscript review, five studies were excluded (Table S1) and finally 12 studies were included [21][22][23][24][25][26][27][28][29][30][31][32] (N = 740 pregnant women) (Figure 1). The characteristics of the included studies are shown in Table 1.…”

Section: Data Search Resultsmentioning

confidence: 99%

“…Data from seven studies [22][23][24]28,29,31,32 (N = 526) were used in the evaluation of FMD% in pregnancy, revealing a significant difference (pooled mean difference −3.12; 95% CI −5.36 to −0.88, I 2 = 96%, p < 0.01) (Figure 2). Data from five 21,[25][26][27]30 (N = 246) were used in the evaluation of FMD% in the post-partum period, revealing a significant difference (pooled mean difference −5.93; 95% CI −9.07 to −2.80, I 2 = 94%, p < 0.01) (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

“…In the sensitivity analysis, data from six studies 23,24,28,29,31,32 (N = 498) were used in the evaluation of FMD% in pregnancy, revealing a significant difference (pooled standardised mean difference −0.42; 95% CI −0.64 to −0.20, I 2 = 39%, p = 0.13) (Figure 4).…”

Section: Sensitivity Analysismentioning

confidence: 99%

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Decreased flow‐mediated dilation in gestational diabetes in pregnancy and post‐partum. A systematic review and meta‐analysis

Chatzakis

Koletsos

Tirta

et al. 2022

Diabetes Metabolism Res

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Aims Gestational diabetes mellitus (GDM) is a common medical complication during pregnancy. Endothelial dysfunction is considered an early step in the progression of atherosclerosis that may contribute to subclinical target organ damage. This meta‐analysis aimed to systemically review the existing data regarding endothelial dysfunction between women with and without GDM during pregnancy and post‐partum using flow‐mediated dilation (FMD). Materials and Methods Eligible studies (cohort and observational) published until October 2021 were identified in the MEDLINE, Scopus, Cochrane Library database and grey literature sources were searched. Results The search yielded 2272 studies, of which 17 were fully reviewed and 12 studies (N = 740 pregnant women) were finally included. Pregnant women with GDM exhibited a significantly lower FMD compared to pregnant women without GDM (pooled mean difference −3.12; 95% CI −5.36 to −0.88). Moreover, in the immediate (1–6 months) post‐partum period, women with previous GDM showed lower FMD compared to healthy women without GDM history (pooled mean difference −7.52; 95% CI −9.44 to −5.59), whereas FMD did not differ in the late post‐partum period (more than 4 years). Conclusions Flow‐mediated dilation is decreased in women with GDM during pregnancy and in the immediate post‐partum period, compared to women without GDM, indicating that the endothelial dysfunction noted during the pregnancy in those women persists in the immediate post‐partum period too. Clinical trial registration PROSPERO CRD42021283113 (http://www.ClinicalTrials.gov).

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Section: Data Search Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Decreased flow‐mediated dilation in gestational diabetes in pregnancy and post‐partum. A systematic review and meta‐analysis

Chatzakis

Koletsos

Tirta

et al. 2022

Diabetes Metabolism Res

View full text Add to dashboard Cite

show abstract

“…Garg et al, measured FMD in 20 GDM patient and compared with 20 healthy age matched pregnant women at 20-22+6 weeks+days and 30-32+6weeks+days and this study concluded that women with GDM had lower FMD in the third trimester compared to the second trimester (6.77 versus 7.78) but the difference was non-significant). 19 Paradisi et al, reported that FMD at third trimester was significantly reduced in women with GDM when compared with controls (mean FMD of 4.1% in GDM vs. 10.9% in controls). 20 Guimaraes DR et al, also reported a similar decrease in mean FMD in the third trimester in patients with GDM as compared to the controls (9.18%, 17.55% respectively).…”

Section: Discussionmentioning

confidence: 98%

Study of endothelial function in pregnant women with gestational diabetes mellitus by flow mediated dilation of brachial artery

Pandey¹,

Goel²,

Malhotra³

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Background: The objective of the study was to assess vascular function in normal pregnant women and women with gestational diabetes and to study its temporal relationship with gestational age at 24-28-week POG and at 36-38-week POG and changes in FMD in postpartum period.Methods: Assessment of vascular function was done at 24-28-week POG, 36-38-week POG and at 6-12-week postpartum by flow mediated dilation of brachial artery in 37 healthy pregnant women and 37 pregnant women with GDM.Results: In GDM group mean FMD at 24-28 weeks of POG, at 36-38 weeks POG was lower as compared to the control group (11.225±6.20,8.464±6.09 versus 14.49±5.21, 10.898±4.12) although the difference in mean FMD in two groups was not statistically significant. It was found that the decrease in FMD at 36-38-week POG as compared to 24-28 weeks POG was statistically significant in both the groups (p<0.001).Conclusions: This study revealed that when endothelial function as assessed by FMD was compared at different period of gestation, the mean decrease in FMD at 36-38-week POG as compared to 24-28-week POG and 6-week post-partum was statistically significant in patients with GDM and as well as the control group, however this trend of change was same in both the groups and was not statistically significant when compared between the two group (GDM versus control). A negative correlation of FMD was found with BMI, and HBA1c, that was stronger in GDM group.

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“…The resulting decreased synthesis and bioavailability of NO is followed by endothelial dysfunction in maternal and placental vessels [ 8 ]. Moreover, combination of insulin resistance and increased glucose concentration leads to endothelial dysfunction in pregnancies with GDM, which is evident even from the first trimester [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Physical Exercise on Oxidation Capacity and Utero-Placental Circulation in Pregnancies with Gestational Diabetes Mellitus and Uncomplicated Pregnancies, a Pilot Study

et al. 2022

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Background: Gestational diabetes mellitus (GDM) is associated with aggravated oxidation capacity and utero-placental circulation, while aerobic exercise could improve both. The study aims to assess oxidation capacity and utero-placental circulation before and after a bout of aerobic exercise in GDM and uncomplicated pregnancies.; Methods: In this cross-sectional study, women with GDM (GDMs) and women with uncomplicated pregnancies(controls), underwent 30 min of moderate intensity cycling. Total antioxidant capacity (TAC), catalase activity (CAT), reduced glutathione (GSH), Uterine Arteries (UtA PI) and Umbilical Artery (UmA PI) pulsatility indexes were estimated prior-to, immediately after and one hour after exercise; Results: In each group, 25 pregnant women were included. In both groups, between prior-to and immediately after exercise, TAC and CAT increased, while GSH decreased, (p < 0.001). In GDMs, CAT was lower than controls at any time point (p < 0.05), while in GDMs delta(Δ) CAT (prior-to and immediately after exercise) was lower than controls (p = 0.003). In GDMs, UtA PI centiles decreased between prior-to and either immediately or one hour after exercise, while they did not change in controls. In GDMs, pre-conceptional BMI and weight gain predicted negatively ΔTAC (prior-to to one hour after exercise); Conclusions: Moderate intensity exercise bout improves oxidation capacity in GDM and uncomplicated pregnancies, although at a lesser extent in the former. Exercise leads to decreased UtA arteries resistance in women with GDM.

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The temporal trend of vascular function in women with gestational diabetes

Cited by 8 publications

References 31 publications

Decreased flow‐mediated dilation in gestational diabetes in pregnancy and post‐partum. A systematic review and meta‐analysis

Decreased flow‐mediated dilation in gestational diabetes in pregnancy and post‐partum. A systematic review and meta‐analysis

Study of endothelial function in pregnant women with gestational diabetes mellitus by flow mediated dilation of brachial artery

The Effect of Physical Exercise on Oxidation Capacity and Utero-Placental Circulation in Pregnancies with Gestational Diabetes Mellitus and Uncomplicated Pregnancies, a Pilot Study

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