title: History of gestational diabetes, insulin resistance and coronary risk.
abstract: The purpose of this study was to examine characteristics associated with the insulin metabolic syndrome, including insulin resistance, abnormal glucose tolerance, dyslipidemia, obesity, and elevated blood pressure, among women who have experienced gestational diabetes. 39 nondiabetic, young (20-42 years), postpartum (3-18 months) white women were recruited from obstetrical clinics. Twenty-one women had a history of gestational diabetes; 18 had uncomplicated pregnancies. Multivariate analyses revealed a significant difference between groups in insulin resistance (M, measured by euglycemic clamp) and insulin levels (from an oral glucose tolerance test), with insulin resistance showing a statistically stronger difference than insulin levels. Groups also differed significantly when compared on a set of variables associated with insulin metabolic syndrome: glucose tolerance, triglycerides, blood pressure, and body-mass index. Using insulin resistance as a covariate eliminated these group differences, suggesting that insulin resistance is the key factor underlying insulin metabolic syndrome. The higher risk of later developing type 2 diabetes and hypertension in women who have a history of gestational diabetes is explicable by their poorer profile on variables associated with insulin metabolic syndrome, and appears to be attributable to insulin resistance. Thus, insulin resistance appears to distinguish young women at risk for cardiovascular disease.
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, Florida 33124-2070, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Davis
authors.forename: M
authors.initials: M
authors.lastname: Gutt
authors.forename: M M
authors.initials: MM
authors.lastname: Llabre
authors.forename: J B
authors.initials: JB
authors.lastname: Marks
authors.forename: M J
authors.initials: MJ
authors.lastname: O'Sullivan
authors.forename: J E
authors.initials: JE
authors.lastname: Potter
authors.forename: J L
authors.initials: JL
authors.lastname: Landel
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.forename: N
authors.initials: N
authors.lastname: Schneiderman
authors.forename: M
authors.initials: M
authors.lastname: Gellman
authors.forename: J S
authors.initials: JS
authors.lastname: Skyler
mesh_terms: D000328:Adult; D001794:Blood Pressure; D015992:Body Mass Index; D003327:Coronary Disease; D016640:Diabetes, Gestational / Q000150:complications*; D005260:Female; D015309:Glucose Clamp Technique; D018149:Glucose Intolerance; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D015999:Multivariate Analysis; D011247:Pregnancy; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
chemical_list: D007328:Insulin; D014280:Triglycerides