Total sialic acid and associated elements of the metabolic syndrome in women with and without previous gestational diabetes.
OBJECTIVE
Inflammatory markers predict type 2 diabetes and relate to the metabolic syndrome. Gestational diabetes mellitus (GDM) predicts type 2 diabetes and may be part of this syndrome. To examine the association of inflammatory markers with GDM, we investigated total sialic acid (TSA) in women with and without previous GDM.


METHODS
All women with GDM and a random sample of women from one center of the Brazilian Study of Gestational Diabetes were invited to return 7 years after their index pregnancy. After an interview, an oral glucose tolerance test and anthropometry were performed. A total of 46 women with and 50 women without previous GDM completed the protocol.


RESULTS
Mean TSA was significantly higher in women with (71.8 +/- 11.1 mg/dl) than without (67.5 +/- 9.8 mg/dl) previous GDM (P < 0.05). In a linear regression model, TSA was 4 mg/dl (P < 0.05) higher in women with previous GDM, after adjustment for BMI, fasting insulin sensitivity, and number of years spent in school. In a similar model, current 2-h plasma glucose levels were associated with higher TSA levels after adjustment for waist-to-hip ratio and the log of triglycerides. TSA was strongly correlated with individual components and aggregates (r = 0.55, P < 0.001) of the metabolic syndrome.


CONCLUSIONS
Increased TSA levels are associated with previous GDM and are strongly linked to the metabolic syndrome. These findings in young women suggest that a chronic mild systemic inflammatory response is an early feature of the metabolic syndrome and that GDM may be a window for its investigation.
Sriharan
Mohanaluxmi
M
Guy's, King's, and St. Thomas' Hospitals School of Medicine, King's College London, London, U.K.
Reichelt
Angela J
AJ
Opperman
Maria Lúcia R
ML
Duncan
Bruce B
BB
Mengue
Sotero S
SS
Crook
Martin A
MA
Schmidt
Maria I
MI
D015415:Biomarkers; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D016640:Diabetes, Gestational / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications / Q000175:diagnosis; D016014:Linear Models; D024821:Metabolic Syndrome / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D019158:N-Acetylneuraminic Acid / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy
D015415:Biomarkers; D019158:N-Acetylneuraminic Acid