title: Does gestational diabetes history increase epicardial fat and carotid intima media thickness?
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) is defined as glucose intolerance that has begun during pregnancy. Recent studies have proven that development of atherosclerosis may be established in this population even without presence of type 2 diabetes. For assessment of atherosclerosis, epicardial fat thickness (EFT) is recently being used as a surrogate marker. In this study, we aimed to prove that women with GDM history are more inclined to have higher EFT levels than women without GDM history.
  
  
  METHODS
  Sixty-two patients with previous GDM and 33 age- and sex-matched controls were allocated. Epicardial fat thicknesses of the subjects were measured with transthorasic echocardiography and carotid intima media thickness (c-IMT) was measured with ultrasound. Insulin resistance (IR) of each subject was assessed with Homeostasis model of assessment-insulin resistance (HOMA-IR).
  
  
  RESULTS
  Carotid IMT and EFT were significantly higher in previous GDM group than controls. Serum gamma-glutamyl transferase (GGT), uric acid, and high-sensitivity C-reactive protein (hs-CRP) levels were also found significantly higher in the patients with previous GDM as compared to the controls. We observed that carotid IMT (β = 310, P = 0.003), total cholesterol (β = 315, P = 0.002), BMI (β = 308, P = 0.002), HbA1c (β = 227, P = 0.018), and HOMA-IR (β = 184, P = 0.049) were independently correlated with EFT.
  
  
  CONCLUSIONS
  Although the number of patients included in this study is limited, high EFT results may indicate presence of atherosclerosis in women with previous GDM.
authors.affiliation: Cardiology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Caliskan
authors.forename: Ozge Telci
authors.initials: OT
authors.lastname: Caklili
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Caliskan
authors.forename: Cevdet
authors.initials: C
authors.lastname: Duran
authors.forename: Faika C
authors.initials: FC
authors.lastname: Çiftçi
authors.forename: Enver
authors.initials: E
authors.lastname: Avci
authors.forename: Hakan
authors.initials: H
authors.lastname: Güllü
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kulaksizoglu
authors.forename: Harun
authors.initials: H
authors.lastname: Koca
authors.forename: Haldun
authors.initials: H
authors.lastname: Muderrisoglu
mesh_terms: D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000175:diagnosis*; D004452:Echocardiography / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D016014:Linear Models; D008875:Middle Aged; D015999:Multivariate Analysis; D010496:Pericardium / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D055815:Young Adult
keywords: atherosclerosis; echocardiography; epicardial fat; gestational diabetes