Publication details

Metabolic syndrome in women with GDM

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Year of publication 2022
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Description Background and aims: Gestational diabetes mellitus (GDM) is one of the most common complications in pregnancy. Women with GDM have a higher occurrence of peripartal complication as well as an increased risk of type 2 diabetes mellitus, metabolic syndrome (MS) and subsequent cardiovascular diseases after delivery or anytime later. However, MS could precede gravidity and GDM could represent manifestation of one of its components. The aims of the study were (i) to detect the prevalence of MS in women in the time of GDM diagnosis, (ii) to detect the prevalence of MS in the sub-group of GDM patients with any form of impaired glucose tolerance after delivery, and (iii) to find whether GDM women with MS have a higher risk of peripartal adverse. Materials and Methods: Study comprised n=455 women with GDM enrolled during 2013-2019. Following GDM diagnosis, subjects were followed in Diabetology centre in Faculty Hospital Brno, 65% (n=295) of them delivered in Faculty Hospital Brno and data on delivery were thus retrievable. 48% (n=219) GDM patients underwent repeated oGTT test up to 1 year after delivery with 11.4% (n=25) manifesting persistence or early conversion of GDM to permanent glucose intolerance (diabetes or prediabetes, evaluated according to WHO criteria). GDM was diagnosed according to IADPSG criteria. IDF criteria for MS definition were modified to pregnancy situation as a presence of a minimum of 3 of 5 criteria: GDM, BMI before pregnancy ?30 kg/m2, blood pressure >130/85mmHg, triacyl-glyceroles (TAG) >1.7mmol/l, high density lipoproteins (HDL) <1.3mmol/l (with exception of BMI all parameters were evaluated in the second trimester of pregnancy). Following perinatal data were analysed: offspring weight (macrosomia), length of delivery, necessity of delivery induction or instrumental delivery, unplanned Caesarean section, Apgar score value. Results: Fully developed MS was detected in 22.6% (n=103) of GDM patients at 24th-28th week of pregnancy. In those with any form of persistent glucose intolerance after delivery the prevalence of MS was as high as 40%. Presence of MS in GDM patients was statistically significantly associated with two peripartal outcomes: higher incidence of pathologic Apgar score and macrosomia (P=0.01 resp. P= 0.0004, chi-square test). Conclusion: Presence of MS in GDM patients is a statistically significant risk factor (P= 0.04 chi-square test) for persistence of impaired glucose tolerance after delivery and selected adverse peripartal outcomes. Acknowledgement Supported by the project National Institute for Research of Metabolic and Cardiovascular Diseases (Programme EXCELES, ID Project No. LX22NPO5104) - Funded by the European Union – Next Generation EU.
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