title: Precocious markers of cardiovascular risk and vascular damage in apparently healthy women with previous gestational diabetes.
abstract: Previous gestational diabetes mellitus (pGDM) indicates future risk for type 2 diabetes (T2DM). Insulin resistance (IR) may precede T2DM in many years and is associated with an increased risk for cardiovascular diseases.
  
  
  OBJECTIVE
  This study aims to identify endothelial dysfunction and cardiovascular risk factors in women with pGDM.
  
  
  METHODS
  This cross-sectional analysis included 45 non diabetic women, 20 pGDM and 25 controls, at least one year after delivery. Body mass index (BMI), abdominal circumference (AC), blood pressure, serum lipids, liver enzymes, uric acid, nonesterified fatty acids, C-reactive protein and plasma glucose, insulin, fibrinogen and plasminogen activator inhibitor 1 were measured. HOMA IR and β were calculated. Pre and post induced ischemia videocapillaroscopy was performed in hand nailfold to evaluate microvascular morphologic aspect and functional response.
  
  
  RESULTS
  AC and fasting glucose were significantly higher in pGDM (p = 0.01 and p = 0.002 respectively). Women with pGDM and BMI < 25 kg/m(2) had significantly higher levels of fasting insulin and HOMA IR than controls (p = 0.008 and 0.05 respectively). Abnormal morphologic findings were more frequent and papillae rectification were 3.3 times more prevalent in pGDM (p = 0.003). Other microvascular parameters did not differ between groups.
  
  
  CONCLUSIONS
  Cardiovascular risk factors and a microcirculation abnormality (papillae rectification) were significantly increased in young non-diabetic women with pGDM.
authors: Nutrology and Diabetes Section, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Lenita
authors: L
authors: Zajdenverg
authors: Nutrology and Diabetes Section, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Melanie
authors: M
authors: Rodacki
authors: Nutrology and Diabetes Section, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Janaina Polo
authors: JP
authors: Faria
authors: Nutrology and Diabetes Section, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Maria Lúcia Elias
authors: ML
authors: Pires
authors: Nutrology and Diabetes Section, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: José Egídio Paulo
authors: JE
authors: Oliveira
authors: Nutrology and Diabetes Section, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
authors: Vera Lúcia Castro
authors: VL
authors: Halfoun
keywords: Cardiovascular risk; Gestational diabetes; Microangiopathy