Open AccessOxidized LDL , insulin resistance and central blood pressure after gestational diabetes mellitus
Author(s) -
VilmiKerälä Tiina,
Palomäki Outi,
Kankkunen Päivi,
Juurinen Leena,
Uotila Jukka,
Palomäki Ari
Publication year - 2016
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/aogs.13029
Subject(s) - medicine , insulin resistance , gestational diabetes , body mass index , endocrinology , blood pressure , obesity , diabetes mellitus , pregnancy , insulin , gestation , biology , genetics
Gestational diabetes mellitus ( GDM ) is an indicator of future cardiovascular disease. We investigated whether sensitive biomarkers of increased cardiovascular risk differ between women with and without a history of GDM few years after pregnancy, and whether obesity affects the results. Material and methods We studied two cohorts – 120 women with a history of GDM and 120 controls, on average 3.7 years after delivery. Circulating concentrations of oxidized low‐density lipoprotein (ox LDL ) were determined by ELISA . The homeostasis model assessment of insulin resistance ( HOMA ‐ IR ) index was used to estimate insulin resistance. Central blood pressure ( cBP ) was measured noninvasively from a radial artery pulse wave. The primary outcomes were possible differences in ox LDL , HOMA ‐ IR or cBP between the groups. Secondly, we investigated the influence of obesity on the results, also using adjusted multiple linear regression analyses. Results Ox LDL concentrations or cBP did not differ between the two cohorts, but HOMA ‐ IR was significantly higher in women with previous GDM than in controls, 1.3 ± 0.9 ( SD ) and 1.1 ± 0.9, respectively ( p = 0.022). In subgroup analyses, HOMA ‐ IR ( p < 0.001), systolic ( p < 0.001) and diastolic ( p < 0.001) cBP were significantly higher in obese subgroups compared with non‐obese ones. Body mass index was an important determinant of HOMA ‐ IR and cBP in multiple linear regression analyses. Conclusions Over 3 years after delivery, women with GDM were still more insulin‐resistant than controls. Obesity turned out to be a more important determinant of insulin resistance and cBP compared with GDM .