INCREASED INTIMA-MEDIA THICKNESS OF CAROTID ARTERIES AND CARDIOVASKULAR RISK FACTORS IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES MELLITUS

Abstract

background Women with gestational diabetes mellitus (GDM) are at an increased risk of the development of type 2 diabetes. Cardiovascular disease is the main reason for the death of individuals with type 2 diabetes. The aim of the study was to find out if women with previous GDM already have the early signs of atherosclerosis and the components of cardiovascular disease. patients and We have compared the intima-media thickness (IMT) and metabolic and cardiovascular risk methods factors of 15 women being from three months to two years after delivery, with previous GDM to 9 post-gestational women with normal glucose tolerance. High-resolution ultrasonography for the noninvasive measurement of the intima-media thickness has been used. The IMT has been expressed as the mean of the three measurements of the far wall at three different sites of the carotid arteries (the common carotid artery, carotid bifurcation and internal carotid artery). The fasting blood glucose, HbA1c, lipid profile, resting blood pressure, waist circumference, body mass index and the smoking status have also been evaluated. Results Women with GDM (age 30.8 ± 6.0 years) compared to women with normal glucose tolerance (age 29.7 ± 2.9 years) have significantly increased IMT of all measured part of the carotid tree (mean left and right sites of the common carotid artery: 0.61 ± 0.08 mm in GDM vs. 0.53 ± 0.03 mm in control, p = < 0.05; carotid bifurcation: 0.85 ± 0.24 mm in GDM vs. 0.62 ± 0.1 mm in control, p = < 0.05; internal carotid artery: 0.66 ± 0.1 mm in GDM vs. 0.53 ± 0.1 mm in control, p = < 0.01). The two groups significantly differ from the body mass index, body waist circumference, in the level of fasting blood glucose and triglyceride, but there are no differences between the groups in the level of whole cholesterol, HDL in LDL cholesterol, systolic and diastolic blood pressure, HbA1c and smoking status. The metabolic syndrome is present in 33.3 percent of women with previous GDM and zero percent of the control group. conclusions The significantly increased intima-media thickness of carotid arteries in women with previous gestational diabetes mellitus vs. women with normal glucose tolerance, demonstrates that women with previous GDM already have early signs of atherosclerosis. The results demonstate the increased risk of cardiovascular disease as well. They also suggest that these women are at high risk not only for type 2 diabetes but also for cardiovascular disease and need appropriate preventive management.