Endothelium-Dependent Hemostatic Factors in Women with Previous Gestational

ABSTRACT

Purpose: Women with previous gestational diabetes mellitus (pGDM) are at increased risk for developing type 2 diabetes and cardiovascular disorders. The aim of this study was to investigate the levels of endothelium-dependent hemostatic factors in women with pGDM.
Material and Method: Eighty women with pGDM and 40 healthy women with no history of pGDM were included. The levels of glucose, insulin, c-peptide, lipids, C-reactive protein (CRP), and endothelium-dependent hemostatic factors, including plasminogen activator inhibitor-1 (PAI-1), von Willebrand factor, fibrinogen, tissue factor (TF), tissue plasminogen activator, and total tissue factor pathway inhibitor (TFPI), were measured.
Results: Women with pGDM had higher levels of CRP (p<0.001), fibrinogen (p=0.001), PAI-1 (p<0.001), TF (p=0.035), and total TFPI (p=0.009) compared to controls. Circulating levels of CRP and PAI-1 were significantly elevated in women with pGDM even after adjustment of body mass index (BMI) (CRP; p=0.022, and PAI-1; p=0.039). PAI-1 levels were positively correlated with BMI (r=0.374, p<0.001), waist-hip ratio (r=0.251, p=0.006), low density lipoprotein -cholesterol (r=0.246, p=0.007), triglyceride (r=0.296, p=0.001), fasting glucose (r=0.339, p<0.001), 2-h. plasma glucose (r=0.247, p=0.007), fasting insulin (r=0.334, p<0.001) and insulin resistance index (r=0.36, p<0.001), and negatively correlated with high-density lipoproteins-cholesterol (r=-0.420, p<0.001) and quantitative insulin sensitivity check index (r=-0.323, p<0.001).
Discussion: Our study shows that women with pGDM exhibit altered levels of endothelium-dependent hemostatic factors which seem to be associated with cardiovascular risk factors.