title: Association of Gestational Diabetes Mellitus With Left Ventricular Structure and Function: The CARDIA Study.
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) predicts incident cardiovascular disease (CVD). However, mechanisms linking GDM to CVD beyond intervening incident diabetes are not well understood. We examined the relation of GDM with echocardiographic parameters of left ventricular (LV) structure and function, which are important predictors of future CVD risk.
  
  
  METHODS
  We studied 609 women (43% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study who delivered one or more births during follow-up and had echocardiograms in 1990-1991 (mean age 28.8 years) and 2010-2011.
  
  
  RESULTS
  During the 20-year follow-up, 965 births were reported, with GDM developing in 64 women (10.5%). In linear regression models adjusted for sociodemographic factors, BMI, physical activity, parity, smoking, use of oral contraceptives, alcohol intake, family history of coronary heart disease, systolic blood pressure, and lipid levels, women with GDM had impaired longitudinal peak strain (-15.0 vs. -15.7%, P = 0.025), circumferential peak strain (-14.8 vs. -15.6%, P = 0.028), lateral e' wave velocity (11.0 vs. 11.8 cm/s, P = 0.012), and septal e' wave velocity (8.6 vs. 9.3 cm/s, P = 0.015) in 2010-2011 and a greater 20-year increase in LV mass indexed to body surface area (14.3 vs. 6.0 g/m(2), P = 0.006) compared with women with non-GDM pregnancies. Further adjustment for incident type 2 diabetes after pregnancy did not attenuate these associations.
  
  
  CONCLUSIONS
  Pregnancy complicated by GDM is independently associated with increased LV mass and impaired LV relaxation and systolic function. Implementation of postpartum cardiovascular health interventions in women with a history of GDM may offer an additional opportunity to reduce future CVD risk.
authors.affiliation: University of Minnesota, Minneapolis, MN dappiah@umn.edu.
authors.forename: Duke
authors.initials: D
authors.lastname: Appiah
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Schreiner
authors.affiliation: Kaiser Permanente Northern California, Oakland, CA.
authors.forename: Erica P
authors.initials: EP
authors.lastname: Gunderson
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: Suma H
authors.initials: SH
authors.lastname: Konety
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Chike C
authors.initials: CC
authors.lastname: Nwabuo
authors.affiliation: University of Arizona College of Medicine, Tucson, AZ.
authors.forename: Imo A
authors.initials: IA
authors.lastname: Ebong
authors.affiliation: University of Minnesota, Minneapolis, MN.
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Whitham
authors.affiliation: Colorado School of Public Health, Aurora, CO.
authors.forename: David C
authors.initials: DC
authors.lastname: Goff
authors.affiliation: Johns Hopkins University, Baltimore, MD.
authors.forename: Joao A
authors.initials: JA
authors.lastname: Lima
authors.affiliation: Kaiser Permanente San Francisco, San Francisco, CA.
authors.forename: Ivy A
authors.initials: IA
authors.lastname: Ku
authors.affiliation: A.I. DuPont Hospital for Children, Wilmington, DE.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Gidding
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology; D016640:Diabetes, Gestational / Q000097:blood / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011247:Pregnancy; D018487:Ventricular Dysfunction, Left / Q000000981:diagnostic imaging / Q000503:physiopathology*