scholarly journals Non-Invasive Detection of Fetal Vascular Endothelial Function in Gestational Diabetes Mellitus

2021 ◽  
Vol 12 ◽  
Author(s):  
Yunyu Chen ◽  
Danping Huang ◽  
Jinrong Liu ◽  
Fangling Zeng ◽  
Guoyi Tang ◽  
...  

ObjectivesEndothelial dysfunction in the fetuses of women with gestational diabetes mellitus (GDM) is associated with their subsequent cardiovascular events. Prenatal assessment of endothelial function in fetuses exposed to intrauterine hyperglycemic environment remains challenging. The aim of this study was to assess the fetal vascular endothelial function in GDM patients using color M-mode derived aortic propagation velocity (APV) and evaluate the correlation of APV with endothelial function biomarkers.MethodsThis observational cross-sectional study included 31 gestational diabetic mothers and 30 healthy pregnant mothers from August 2019 to January 2020. Clinical data were compared between the groups. Fetal APV was measured using color M-mode echocardiography at late gestation. Concentrations of endothelial biomarkers including von Willebrand Factor (vWF), vascular endothelial-cadherin and endothelin-1 in umbilical cord serum were assessed. Measurements between diabetic group and controls were compared.ResultsvWF was the only endothelial functional marker that differed between the two groups. Fetuses in the GDM group had significantly lower APV levels and higher vWF levels compared with the healthy controls (P < 0.05). There was a moderate but significant correlation between APV and vWF (r =−0.58, P < 0.001). There were no associations between APV and ventricular wall thickness or umbilical artery pulsatility index.ConclusionsColor M-mode propagation velocity of aorta is a non-invasive, practical method that correlates well with GDM and fetal endothelial function. This novel metric could contribute to recognizing early vascular functional alterations and hence represents a potential strategy for early risk factor surveillance and risk modification.

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Qiuan Zhong ◽  
Qingjiao Nong ◽  
Baoyu Mao ◽  
Xue Pan ◽  
Liuren Meng

Impaired vascular endothelial function has attracted attention as a prognostic indicator of cardiovascular prevention. The association between impaired endothelial function and cardiovascular risk in the asymptomatic population, however, has been poorly explored. We evaluated the association of brachial artery flow-mediated dilation (FMD) with Framingham-estimated 10-year cardiovascular disease (CVD) risk in subjects free of CVD, especially by cardiovascular risk profiles. In total, 680 adults aged 30-74 years were enrolled from Rongan and Rongshui of Liuzhou, Guangxi, China, through a cross-sectional study in 2015. In the full-adjusted model, the odds ratio for the estimated 10-year CVD risk comparing the low FMD (<6%) with the high FMD (≥10%) was 2.81 (95% confidence interval [CI]: 1.21, 6.53;Pfor trend = 0.03). In subgroup analyses, inverse associations between FMD and the estimated 10-year CVD risk were found in participants with specific characteristics. The adjusted odds ratios, comparing the 25th and the 75th percentiles of FMD, were 2.77 (95% CI: 1.54, 5.00) for aged ≥60 years, 1.77 (95% CI: 1.16, 2.70) for female, 1.59 (95% CI: 1.08, 2.35) for nonsmokers, 1.74 (95% CI: 1.02, 2.97) for hypertension, 1.59 (95% CI: 1.04, 2.44) for normal glycaemia, 2.03 (95% CI: 1.19, 3.48) for C-reactive protein ≥10 mg/L, and 1.85 (95% CI: 1.12, 3.06) for eGFR <106 mL/minute per 1.73 m2. Therefore, impaired endothelial function is associated with increased CVD risk in asymptomatic adults. This inverse association is more likely to exist in subjects with higher cardiovascular risk.


2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Gisele Seabra ◽  
Cláudia Saunders ◽  
Patrícia de Carvalho Padilha ◽  
Lenita Zajdenverg ◽  
Letícia Barbosa Gabriel da Silva ◽  
...  

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1011
Author(s):  
Sofia Nevander ◽  
Eva Landberg ◽  
Marie Blomberg ◽  
Bertil Ekman ◽  
Caroline Lilliecreutz

Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.


2020 ◽  
Author(s):  
Caiying Feng ◽  
Jie You ◽  
Guixia Chen ◽  
Hongli Su ◽  
Li Zhang ◽  
...  

Abstract Background Previous studies have discovered that zinc-α2-glycoprotein is related to insulin resistance and lipid metabolism. The aim of the study is to explore the change of serum zinc-α2-glycoprotein(ZAG) and its related factors in gestational diabetes mellitus(GDM). Methods Eighty newly diagnosed GDM patients were enrolled in study group, and 80 normal pregnant women were selected as control group. The differences of baseline data between the two groups were compared, and the change of serum ZAG level and its relationship with related indexes was analyzed. Results Compared to control group, the level of serum ZAG in the study group decreased [(43.94 ± 14.51)mg/L vs. (62.57 ± 19.05)mg/L, P < 0.001]. Pearson correlation (or Spearman correlation) analysis showed that serum ZAG level was negatively correlated with FPG, FINS, HOMA-IR and TG (P < 0.05) and positively correlated with HDL(P < 0.05). Multiple linear regression showed that HDL, FINS, HOMA-IR were independent factors of serum ZAG(P < 0.001). Conclusion The level of serum ZAG in patients with gestational diabetes mellitus decreased, and HDL, FINS and HOMA-IR are the influencing factors in study group. Trial registration: The study registered in the Chinese Clinical Trial Registry(Chi CTR2000028811).


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mayumi Matsunaga ◽  
Yaeko Kataoka ◽  
Yumiko Igarashi ◽  
Toshiko Fukui ◽  
Masumi Imura ◽  
...  

Abstract Background Despite the benefits of breastfeeding for women with Gestational Diabetes Mellitus (GDM) and their infants, breastfeeding is less likely to be performed by this group. This study aimed to examine the current levels of implementation of breastfeeding support to women with GDM in Japan and to clarify barriers to promoting breastfeeding among this population. Methods A 25-item questionnaire was developed by the authors to investigate the current levels of implementation of breastfeeding support for women with GDM provided in hospitals, and to explore barriers for promoting breastfeeding among these women. The questionnaire was sent to all 1046 hospitals facilitating childbirth in Japan. Descriptive statistics were used to analyze the quantitative data, and content analysis was used to analyze qualitative data from the open-ended questions. Results All 296 respondents were included in this study. Regarding breastfeeding support, 95.2% of the respondents provided general information on breastfeeding to GDM women during antenatal midwife consultations. However, the benefits of breastfeeding for preventing type 2 diabetes were addressed by only 48.0%. Likewise, although follow-up services (e.g., telephone support or breastfeeding consultations) were conducted in 88.9% of hospitals, only 50.7% of hospitals informed women that breastfeeding decreases the risk of developing type 2 diabetes after GDM. Regarding barriers, seven categories and 20 subcategories about promoting breastfeeding for women with GDM were extracted and abstracted into the following three themes: Barriers associated with mother and infant, Barriers associated with health professionals, and Organizational barriers. Conclusions In Japan, most hospitals that responded provided general breastfeeding support from the antenatal to postpartum periods. However, the benefits of breastfeeding in terms of preventing the incidence of type 2 diabetes following GDM were insufficiently communicated to women with GDM. Furthermore, there were numerous barriers to promoting breastfeeding among women with GDM.


Author(s):  
Priyanka Inaniya ◽  
B S Meena ◽  
Mohan Lal Meena ◽  
Aparna Sharma ◽  
Shalini Rathore

Background: The present study aimed to study the demographic profile women with gestational diabetes mellitus Methods: This hospital based cross-sectional study Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: Mean age of patients was 27.68 ± 4.4 Yrs. Most of the study subjects in GDM group (54.7%) were Hindu. Study subjects in GDM group were almost equally from rural (50.7%).Most of the study subjects in both GDM group (88%) were housewives. Habit of smoking was found in only 6.7% females in GDM group. Habit of alcohol was found in 4% females in GDM group. Family history of diabetes was seen more in females with GDM (17.3%). Conclusion: This study concluded that the socio demographic factors influence the occurrence of GDM. Keywords: GDM, Age, Gravida


2021 ◽  
Author(s):  
Xiaoyun Yang ◽  
Weiqin Li ◽  
Wei Li ◽  
Huikun Liu ◽  
Leishen Wang ◽  
...  

Abstract Background Some studies have found that branched amino acid (BCAA) is associated with the risk of obesity among general population, however, not all the results were consistent. The present study aimed to investigate the association of daily BCAA intakes with the risk of postpartum overweight and abdominal obesity among women with prior gestational diabetes mellitus (GDM). Methods We performed a cross-sectional study of 1263 women with prior GDM at 1–5 years post-delivery. Logistic regression models were used to estimate the association of daily dietary intakes of BCAAs with the risk of overweight and abdominal obesity. Results The multivariable-adjusted odds ratio (OR) across quartiles of daily BCAA intakes were 1.42 (95% confidence interval [CI] 1.02–1.97), 1.00 (reference), 1.21 (95% CI 0.88–1.68), and 1.31 (95% CI 0.95–1.81) for general overweight, and 1.38 (95% CI 0.99–1.90), 1.00, 1.19 (95% CI 0.86–1.64), and 1.43 (95% CI 1.04–1.98) for abdominal obesity, respectively. Only women with the lowest quartile of daily BCAA intakes significantly increased the risks of general overweight (OR 1.49; 95 %CI 1.06–2.09) and abdominal obesity (OR 1.50; 95 %CI 1.08–2.11) compared with women at quartile 2 of daily BCAA intakes after further adjustment of daily energy intake. Conclusions The present study indicated U-shaped associations between daily BCAA intakes and the risk of general overweight and abdominal obesity among women with prior GDM.


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