title: Hidden metabolic disturbances in women with normal glucose tolerance five years after gestational diabetes.
abstract: Background. The study aimed to assess whether women with prior gestational diabetes (pGDM), despite maintenance of normal glucose tolerance (NGT) five years after delivery, display metabolic disturbances compared to healthy controls. Methods. 45 pGDM with NGT were compared to 18 women without a history of GDM (CON), matched for age (37.0 ± 4.1 versus 35.2 ± 5.3, P = ns) and BMI (24.3 ± 3.1 versus 23.3 ± 3.3, P = ns). Metabolic parameters were derived from oral and intravenous glucose tolerance tests; furthermore lipid profile, C-reactive protein (CRP), adiponectin, leptin, and glucagon were assessed. Results. Five years postpartum, pGDM had increased glucose concentrations during the OGTT (AUC: 1.12 ± 0.15 versus 1.0 ± 0.12 mol/L ∗ min, P = 0.003) and insulin sensitivity was decreased compared to CON (OGIS: 467.2 ± 64.1 versus 510.6 ± 53.1 mL/min ∗ m(2), P = 0.01). pGDM had lower adiponectin (8.1 ± 2.6 versus 12.6 ± 5.3, P < 0.008) but increased waist circumference and CRP compared to CON. Conclusions. Despite diagnosis of normal glucose tolerance, pGDM are characterized by hyperglycemia and insulin resistance compared to healthy controls, accompanied by decreased adiponectin and increased CRP concentrations, thus linking metabolic disturbances to an increased cardiovascular risk in pGDM.
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors: Yvonne
authors: 0000-0002-0555-9044
authors: Y
authors: Winhofer
authors: Metabolic Unit, Institute of Biomedical Engineering, National Research Council, 35127 Padova, Italy.
authors: Andrea
authors: A
authors: Tura
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors: Anita
authors: 0000-0002-1679-3098
authors: A
authors: Thomas
authors: Division of Nephrology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria.
authors: Thomas
authors: T
authors: Prikoszovich
authors: Division of Nephrology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria.
authors: Christine
authors: C
authors: Winzer
authors: Metabolic Unit, Institute of Biomedical Engineering, National Research Council, 35127 Padova, Italy.
authors: Giovanni
authors: 0000-0002-4000-2583
authors: G
authors: Pacini
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors: Anton
authors: A
authors: Luger
authors: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
authors: Alexandra
authors: 0000-0002-3520-4105
authors: A
authors: Kautzky-Willer