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- Mustafa Caliskan, Yasar Turan, Zuhal Caliskan, Hakan Gullu, Faika Ceylan Ciftci, Enver Avci, Cevdet Duran, Osman Kostek, Ozge Telci Caklili, Harun Koca, and Mustafa Kulaksizoglu.
- a Istanbul Medeniyet University , Cardiology and Internal Medicine Department , Istanbul , Turkey.
- Ann. Med. 2015 Jan 1; 47 (7): 615623615-23.
BackgroundGestational diabetes mellitus (GDM) is a prediabetic state that is known to increase the risk of cardiovascular diseases. We have investigated coronary flow velocity reserve (CFVR) and epicardial fat thickness (EFT), and left ventricular diastolic function in patients with a history of previous GDM (p-GDM).MethodsNinety-three women with GDM history and 95 healthy women without GDM history were recruited. We used transthoracic Doppler echocardiography to assess CFVR, EFT, and left ventricular diastolic function. Insulin resistance of each subject was assessed with homeostasis model assessment insulin resistance (HOMA-IR). Hemoglobin A1c and high-sensitivity C-reactive protein (hsCRP) were also measured in all patients.ResultsCFVR values were significantly lower (2.34 ± 0.39 versus 2.80 ± 0.24, p < 0.001) and EFT values were significantly higher in patients with p-GDM than the control group (5.5 ± 1.3 versus 4.3 ± 1.1, p < 0.001). E/E' ratio (7.21 ± 1.77 versus 6.53 ± 1.38, p = 0.003), hemoglobin A1c (5.2 ± 0.4 and 5.0 ± 0.3, p = 0.001), HOMA-IR (2.8 ± 1.4 versus 1.7 ± 0.9, p = 0.04), and hsCRP levels were significantly higher in the p-GDM group than the control group. Multivariate analysis revealed that gestational diabetes history is independently associated with CFVR.ConclusionWomen with a GDM history may be at more risk regarding coronary microvascular dysfunction compared to the healthy ones.
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