Document Detail


The graded relationship between glucose tolerance status in pregnancy and postpartum levels of low-density-lipoprotein cholesterol and apolipoprotein B in young women: implications for future cardiovascular risk.
MedLine Citation:
PMID:  20631030     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT AND OBJECTIVE: Both gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) identify women at risk of future cardiovascular disease, although the mediators of this risk are unknown. Because lipid factors can contribute to cardiovascular risk, we sought to characterize the relationship between gestational glucose tolerance status and lipid profile in pregnancy and the postpartum. DESIGN, SETTING, AND PARTICIPANTS: Fasting lipids were measured in 482 women in pregnancy and at 3 months postpartum. Antepartum glucose challenge test (GCT) and oral glucose tolerance test (OGTT) defined four gestational glucose tolerance groups: GDM (n = 136), GIGT (n = 89), abnormal GCT with normal glucose tolerance (NGT) on OGTT (abnormal GCT NGT) (n = 170), and normal GCT with NGT on OGTT (normal GCT NGT) (n = 87). RESULTS: In pregnancy, there were no significant differences between the groups in total and low-density lipoprotein (LDL) cholesterol, triglycerides, total cholesterol to high-density lipoprotein (HDL) cholesterol ratio, apolipoprotein B (apoB), apolipoprotein A1 (apoA1), and apoB to apoA1 ratio. At 3 months postpartum, however, each of the following lipid parameters progressively increased from normal GCT NGT to abnormal GCT NGT to GIGT to GDM: total cholesterol (P = 0.0047), LDL (P = 0.0002), triglycerides (P = 0.0002), total cholesterol to HDL ratio (P < 0.0001), apoB (P = 0.0003), and apoB to apoA1 ratio (P = 0.0014). Furthermore, on multiple linear regression analyses, GDM emerged as an independent predictor of postpartum total cholesterol (t = 3.09, P = 0.0021), LDL (t = 3.81, P = 0.0002), triglycerides (t = 3.38, P = 0.0008), total cholesterol to HDL ratio (t = 3.76,P = 0.0002), apoB (t = 4.12, P < 0.0001), and apoB to apoA1 ratio (t = 3.07, P = 0.0023). GIGT was an independent predictor of postpartum total cholesterol to HDL ratio (t = 2.27, P = 0.0239), apoB (t = 2.04, P = 0.0416), and apoB to apoA1 ratio (t = 1.97, P = 0.049). CONCLUSIONS: Compared with their peers, women with GDM and GIGT have a more atherogenic lipid profile by 3 months postpartum, characterized by increased LDL and apoB.
Authors:
Ravi Retnakaran; Ying Qi; Philip W Connelly; Mathew Sermer; Anthony J Hanley; Bernard Zinman
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-07-14
Journal Detail:
Title:  The Journal of clinical endocrinology and metabolism     Volume:  95     ISSN:  1945-7197     ISO Abbreviation:  J. Clin. Endocrinol. Metab.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-08     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375362     Medline TA:  J Clin Endocrinol Metab     Country:  United States    
Other Details:
Languages:  eng     Pagination:  4345-53     Citation Subset:  AIM; IM    
Affiliation:
Leadership Sinai Centre for Diabetes, 60 Murray Street, Suite L5-039, Mailbox 21, Toronto, Ontario, Canada M5T 3L9. rretnakaran@mtsinai.on.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Apolipoproteins B / blood*
Blood Glucose / analysis,  metabolism*
Cardiovascular Diseases / blood,  diagnosis,  etiology*
Case-Control Studies
Cholesterol, LDL / blood*
Diabetes, Gestational / blood,  diagnosis,  metabolism
Female
Glucose Intolerance / blood,  complications,  diagnosis
Glucose Tolerance Test
Health Status
Humans
Postpartum Period / blood*
Pregnancy / blood*,  metabolism
Pregnancy Complications / blood,  diagnosis,  metabolism
Prognosis
Regression Analysis
Risk Factors
Time Factors
Grant Support
ID/Acronym/Agency:
MOP-67063//Canadian Institutes of Health Research; MOP-84206//Canadian Institutes of Health Research
Chemical
Reg. No./Substance:
0/Apolipoproteins B; 0/Blood Glucose; 0/Cholesterol, LDL

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