Elevation of sE-Selectin Levels 2每24 Months following Gestational Diabetes Is Associated with Early Cardiometabolic Risk in Nondiabetic Women

作者：Alina Sokup; Barbara Ruszkowska; Barbara Goralczyk; Krzysztof Goralczyk; Marek Szymaski; Marek Grabiec; Danuta Ro

来源：International Journal of Endocrinology, 2012.

DOI：10.1155/2012/278050

Objective. We hypothesised that the endothelial dysfunction is associated with early glucose dysregulation and/or atherosclerosis risk factors in nondiabetic women with a previous history of gestational diabetes (pGDM). Material/Methods. Anthropometric parameters, glucose regulation (OGTT), insulin resistance (HOMA), lipids, biomarkers of endothelial dysfunction, and inflammation were evaluated in 85 women with pGDM and in 40 controls 2每24 months postpartum. Results. The pGDM group consisted of 67% normoglycemic women (pGDM-N) and 33% with prediabetic state (pGDM-P). The BMI, waist circumference, fasting and 2ˋh glucose (OGTT), soluble adhesion molecules, tissue plasminogen activator antigen, high sensitivity C-reactive protein, total-, LDL-cholesterol, and triglycerides/HDL-cholesterol ratio were higher in the pGDM women compared with the controls. After adjustment for BMI and fasting glucose, only higher triglycerides, higher TG/HDL and lower HDL-cholesterol were associated with pGDM. The pGDM-P differed from pGDM-N for only higher triglycerides and TG/HDL. The plasma level of sE-selectin was not independently associated with glucose concentration in pGDM group. sE-selectin level correlated with triglycerides, TG/HDL, plasminogen activator inhibitor-1 antigen, and sICAM-1. Conclusions. sE-selectin level correlated with components of metabolic syndrome, but only the atherogenic lipid profile was independently associated with a previous history of GDM in nondiabetic women 2每24 months postpartum. 1. Introduction Women with the previous history of gestational diabetes mellitus (pGDM) have a significantly increased risk of type 2 diabetes and cardiovascular disease in the next years after delivery [1]. Very important problem is both GDM and its future consequences are drastically increasing public health and global problem which requires specific preventive strategies. In the years postpartum, women with pGDM have an increased cardiometabolic derangement, including vascular risk factors and early vascular dysfunction [2每4]. Several studies performed early (6 weeks-2 years) after delivery have found the association of cardiovascular risk factors with glucose intolerance, and in particular with type 2 diabetes [5, 6]. Shah et al. [1] have observed that there is an increased prevalence of metabolic syndrome in the third month postpartum among women with even mild glucose intolerance during pregnancy. Thus, it is possible that different stages of glucose dysregulation diagnosed during pregnancy are associated with early cardiovascular risk postpartum [7]. It