title: Noninvasive assessment of subclinical atherosclerosis in normotensive gravidae with gestational diabetes.
abstract: OBJECTIVE
  Carotid artery intima-media thickness (CIMT), hyperhomocysteinemia, microalbuminuria, and nitric oxide reflect subclinical atherosclerosis and predict the risk of future cardiovascular events. We aimed to evaluate the presence of subclinical atherosclerosis and endothelial dysfunction in normotensive patients with gestational diabetes mellitus (GDM) noninvasively.
  
  
  METHODS
  We enrolled 41 normotensive patients with GDM and 44 healthy gravidae in the study. Serum homocysteine and nitric oxide levels, urinary albumin excretion (microalbuminuria), and CIMT were evaluated along with lipid parameters and anthropometric measurements.
  
  
  RESULTS
  Patients with GDM had significantly higher levels of serum homocysteine, urinary albumin excretion, and increased CIMT (p < 0.001, p=0.005, and p < 0.001, respectively). Nitric oxide levels were significantly reduced in the patient group (p < 0.001). There was a significant difference between groups in terms of low-density lipoprotein (LDL) but not of high-density lipoprotein (HDL) and triglyceride levels. A significant correlation was observed between CIMT and serum LDL, HDL, homocysteine, nitric oxide levels, and urinary albumin excretion. Microalbuminuria was significantly correlated with serum homocysteine levels (p=0.03) but not with nitric oxide.
  
  
  CONCLUSIONS
  Independent of elevated blood pressure, subclinical atherosclerosis and endothelial dysfunction exist in normotensive patients with GDM. Further studies with a large number of participants are required to clarify these data.
authors.affiliation: Faculty of Medicine, Yuzuncu Yil University, 65080, Van, Turkey.
authors.forename: A E
authors.initials: AE
authors.lastname: Atay
authors.forename: H
authors.initials: H
authors.lastname: Simsek
authors.forename: B
authors.initials: B
authors.lastname: Demir
authors.forename: M N
authors.initials: MN
authors.lastname: Sakar
authors.forename: M
authors.initials: M
authors.lastname: Kaya
authors.forename: S
authors.initials: S
authors.lastname: Pasa
authors.forename: S
authors.initials: S
authors.lastname: Demir
authors.forename: D
authors.initials: D
authors.lastname: Sit
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000097:blood / Q000175:diagnosis; D050197:Atherosclerosis / Q000097:blood / Q000175:diagnosis*; D059168:Carotid Intima-Media Thickness; D008078:Cholesterol, LDL / Q000097:blood; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000175:diagnosis; D007231:Infant, Newborn; D009569:Nitric Oxide / Q000097:blood; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000175:diagnosis*; D011295:Prenatal Care; D012307:Risk Factors; D055815:Young Adult
chemical_list: D008078:Cholesterol, LDL; D009569:Nitric Oxide