title: Aortic Stiffness and Cardiovascular Risk in Women with Previous Gestational Diabetes Mellitus.
abstract: Gestational diabetes mellitus (GDM) is a significant risk factor for cardiovascular disease (CVD) in later life, but the mechanism remains unclear. The aim of the study was to investigate indices of glucose metabolism, dyslipidemia, and arterial stiffness (as measured by pulse wave velocity (PWV)), in women with and without a history of GDM, using both the old WHO and new IADPSG diagnostic criteria, at 5 years after the index pregnancy. Dyslipidemia and PWV were used as surrogate markers for CVD risk. The population-based prospective cohort included 300 women from the original STORK study. All participants had an oral glucose tolerance test (OGTT) during pregnancy. Five years later, the OGTT was repeated along with dual-energy x-ray absorptiometry, lipid analysis, and PWV analysis. Measurements were compared between those women who did and did not have GDM based on both the WHO and IADPSG criteria. We found that women with GDM based on the old WHO criteria had higher CVD risk at 5 years than those without GDM, with markedly elevated PWV and more severe dyslipidemia (higher triglycerides (TG)/HDL cholesterol ratio). After adjusting for known risk factors, the most important predictors for elevated PWV and TG/HDL-C ratio at 5-year follow-up were maternal age, BMI, GDM, systolic blood pressure, and indices of glucose metabolism in the index pregnancy. In conclusion, we found a higher risk for CVD, based on the surrogate markers PWV and TG/HDL-C ratio, at 5-year follow-up in women diagnosed with GDM in the index pregnancy when using the old WHO diagnostic criteria.
authors: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Mother Infant Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America.
authors: Tove
authors: T
authors: Lekva
authors: Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: Jens
authors: J
authors: Bollerslev
authors: Mother Infant Research Institute, Tufts Medical Center, Boston, Massachusetts, United States of America; Department of Obstetrics & Gynecology, Tufts Medical Center and Tufts University School of Medicine, Boston, Massachusetts, United States of America.
authors: Errol R
authors: ER
authors: Norwitz
authors: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway; Section of Clinical Immunology and Infectious Diseases, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors: Pål
authors: P
authors: Aukrust
authors: Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Obstetrics, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors: Tore
authors: T
authors: Henriksen
authors: Research Institute of Internal Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: Thor
authors: T
authors: Ueland
mesh_terms: D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D001786:Blood Glucose / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications*; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology*; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011247:Pregnancy; D063177:Pulse Wave Analysis; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides