Small artery function 2 years postpartum in women with altered glycaemic distributions in their preceding pregnancy

Moulinath Banerjee , Simon G Anderson , Rayaz A Malik , Clare E Austin , J Kennedy Cruickshank (1)

1 Cardiovascular Sciences

Gestational diabetes (GDM) is associated with later adverse cardiovascular risk. This study examined the relationship between glycaemia during pregnancy and small artery function and structures some 2 years post-partum. Women were originally enrolled in the HAPO study from which they were classified by their glycaemic distribution during pregnancy as controls (in the lower half of the distribution), upper quartile (UQ - in the upper quartile of the glycaemic distribution) or having had overt GDM. Sub-cutaneous arteries from gluteal fat biopsy taken at follow-up 2 years later were examined using wire myography. Small artery structure, stiffness and vasoconstrictor responses were similar across groups. Maximal endothelium-dependent dilation to carbachol was impaired in arteries from both GDM (43.3%, n=8, p=0.01) and UQ (51.7%, n=13, p=0.04) women despite generally 'normal' current glycaemia (controls (72.7%, n=8). Inhibition of nitric oxide synthase ((NOS) significantly reduced maximum endothelium-dependent dilatation in controls but had no effect on arteries from UQ and GDM women suggesting impaired NOS activity in these groups. Endothelium-independent dilation was unaffected in arteries from previous GDM & UQ women when compared with the control group. Multiple regression analysis suggested that BMI at biopsy was the most potent factor independently associated with small artery function, with no effect of current glycaemia. Overweight women with either GDM, or marginally raised glycaemia during pregnancy (our UQ group), had normal vascular structure and stiffness but clearly detectable progressively impaired endothelium-dependent function at 2 years follow-up. These results suggest that vascular pathology, which may still be reversible, is detectable very early in women at risk of decline into type 2 diabetes.

Mots clés: Medicine

Domaines: Médecine humaine et pathologie

Moulinath Banerjee, Simon G Anderson, Rayaz A Malik, Clare E Austin, J Kennedy Cruickshank. Small artery function 2 years postpartum in women with altered glycaemic distributions in their preceding pregnancy. Clinical Science, 2011, 122 (2), pp.53-61. ⟨10.1042/CS20110033⟩. ⟨hal-00733886⟩