title: Triglycerides as an early pathophysiological marker of endothelial dysfunction in nondiabetic women with a previous history of gestational diabetes.
abstract: OBJECTIVE
  To investigate whether baseline triglyceride levels are associated with early glucose dysregulation and/or cardiovascular risk in women with a previous history of gestational diabetes.
  
  
  METHODS
  Prospective postpregnancy cohort study.
  
  
  METHODS
  Polish university hospitals.
  
  
  METHODS
  Participants included 125 women with previous gestational diabetes and 40 women with normal glucose regulation during pregnancy.
  
  
  METHODS
  All women were studied 2-24 months (mean 12 ± 10 months) after the index pregnancy. Women with previous gestational diabetes were divided into tertiles in accordance with baseline triglyceride levels.
  
  
  METHODS
  We assessed glucose regulation (oral glucose tolerance test), insulin resistance (homeostasis model assessment), markers of endothelial dysfunction (soluble: intercellular adhesion molecule-1, vascular cell adhesion molecule-1, E-selectin, tissue plasminogen activator antigen, von Willebrand factor antigen), fibrinolysis (plasminogen activator inhibitor antigen), inflammation (high-sensitivity C-reactive protein) and lipid levels.
  
  
  RESULTS
  Women with previous gestational diabetes (78% normal glucose regulation, 22% impaired glucose tolerance) had a high cardiometabolic risk profile compared with control women (100% normal glucose regulation). Baseline triglycerides >0.83 mmol/l were associated with a higher prevalence of impaired glucose tolerance, higher high-sensitivity C-reactive protein and triglyceride/high-density lipoprotein-cholesterol ratio. Triglycerides >1.22 mmol/l were associated with higher body fat indexes, higher insulin resistance, higher levels of endothelial dysfunction biomarkers, higher plasminogen activator inhibitor antigen and dyslipidemia. Only E-selectin was independently associated with triglyceride levels.
  
  
  CONCLUSIONS
  Baseline triglyceride levels are a cardiovascular risk marker as well as a pathophysiological parameter independently associated with endothelial dysfunction in nondiabetic women with previous gestational diabetes at 2-24 months after an index pregnancy. Normalization of triglycerides should be included in preventive therapy after a pregnancy complicated by gestational diabetes.
authors.affiliation: Department of Gastroenterology, Angiology and Internal Diseases, Nicolaus Copernicus University, Collegium Medicum, Dr J. Biziel University Hospital, Bydgoszcz, Poland. alinasokup@o2.pl
authors.forename: Alina
authors.initials: A
authors.lastname: Sokup
authors.forename: Barbara
authors.initials: B
authors.lastname: Góralczyk
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Góralczyk
authors.forename: Danuta
authors.initials: D
authors.lastname: Rość
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D002784:Cholesterol / Q000097:blood; D016640:Diabetes, Gestational; D019040:E-Selectin / Q000097:blood; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000209:etiology*; D006801:Humans; D007328:Insulin / Q000097:blood; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D049590:Postpartum Period / Q000097:blood*; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D014280:Triglycerides / Q000097:blood*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood; D014652:Vascular Diseases / Q000097:blood / Q000209:etiology*; D014841:von Willebrand Factor / Q000276:immunology / Q000378:metabolism
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D019040:E-Selectin; D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1; C546936:SELE protein, human; C051321:SERPINE1 protein, human; D014280:Triglycerides; D019010:Vascular Cell Adhesion Molecule-1; C029417:Von Willebrand antigen; D014841:von Willebrand Factor; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein; D002784:Cholesterol; D010959:Tissue Plasminogen Activator