Association of metabolic syndrome with inflammatory mediators in women with previous gestational diabetes mellitus

Journal of Diabetes & Metabolic Disorders

Hossein Fakhrzadeh⁴  Mojde Mirarefin⁶  Bagher Larijani¹  Arash Hossein-Nezhad²  Zohre Badamchizadeh³  Farshad Sharifi⁵  Banoo Edalat⁶ 

[1] Professor of Internal Medicine, Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Assistant Professor of Genetics, Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Bachelor of Nursing, Elderly Health Research Center, Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran;Associate Professor of Cardiology, Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran;PHD of Geriatric Epidemiology, Tehran, Iran;Masters of Nutrition, Elderly Health Research Center, Endocrinology & Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran

关键词: Metabolic syndrome X;    Diabetes gestational;    Inflammation mediators;   

Others  :  807111
DOI  :  10.1186/2251-6581-12-8

 received in 2012-07-03, accepted in 2013-01-09,  发布年份 2013

【 摘 要 】

Background

An increased risk of metabolic syndrome (MS) has been observed among women with previous gestational diabetes mellitus (pGDM). Increased inflammatory markers such as C-reactive protein (CRP) and interleukin 6 (IL-6) usually accompany. We performed this survey to examine the relationship between pGDM and MS, CRP and IL-6.

Methods

77 women with pGDM and 67 randomly sampled women free from GDM participated in this study, 2–3 years after index pregnancy. Laboratory and anthropometric measurements were performed. MS was defined according to ATP III criteria. Statistical analyses were conducted using SPSS 18.

Results

CRP were different between groups with and without pGDM [2.69 (2.86 mg/dl and 1.56 (1.39) mg/dl, respectively; p < 0.01]. The presence of each MS component by itself was associated with significantly higher CRP Levels, except for fasting blood glucose. In linear regression models, CRP and IL-6 were significantly associated with BMI (β =0. 25, 0.23; p < 0.01), waist circumference (β=0. 27, 0.05; p < 0.01) and HOMA-IR (β=0. 39, 0.39; p < 0.01). After adjustment for age and BMI the occurrence of pGDM in the group with both high CRP and MS was significantly associated with CRP level (OR= 5.11; CI=1.59-16.43; p < 0.01).

Conclusion

Since CRP and Il-6 were higher in women with both pGDM and MS it appears that the presence of pGDM with MS components have a synergistic effect on the elevation of serum levels of inflammatory markers which can be partly as a result of visceral obesity. Further long-term studies are necessary to confirm the relationship between CRP, IL-6 and MS in women with pGDM.

【 授权许可】

   
2013 Edalat et al.; licensee BioMed Central Ltd.

【 图 表 】

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【 参考文献 】

• [1]Buchanan TA, Xiang AH: Gestational diabetes mellitus. J Clin Invest 2005, 115:485-91.
• [2]Hossein-Nezhad A, Maghbooli Z, Vassigh AR: Prevalence of gestational diabetes mellitus and pregnancy outcomes in Iranian women. Taiwan J Obstet Gynecol 2007, 46(3):236-241.
• [3]Kim C, Newton KM, Knopp RH: Gestational diabetes and the incidence of type 2 diabetes. Diabetes Care 2002, 25:1862-1868.
• [4]Metzger BE, Cho NH, Roston SM: Prepregnancy weight and antepartum insulin secretion predict glucose tolerance five years after gestational diabetes mellitus. Diabetes Care 1993, 16:1598-1605.
• [5]Feig DS, Zinman B, Wang X, Hux JE: Risk of development of diabetes mellitus after diagnosis of gestational diabetes. CMAJ 2008, 179(3):229-234.
• [6]Kannel WB, McGee DL: Diabetes and cardiovascular disease: the Framingham study. JAMA 1979, 241:2035-8.
• [7]Di Cianni G, Lencioni C, Volpe L: C-reactive protein and metabolic syndrome in women with previous gestational diabetes. Diabetes Metab Res Rev 2007, 23(2):135-140.
• [8]Ferraz TB, Motta RS, Ferraz CL: C-reactive protein and components of metabolic syndrome in Brazilian women with previous gestational diabetes. Diabetes Res Clin Pract 2007, 78(1):23-29.
• [9]Wolf M, Sandler L, Hsu K: First- trimester C-reactive protein and subsequent gestational diabetes. Diabetes Care 2003, 26(3):819-24.
• [10]Barzilay JI, Abraham L, Heckbert SR: The relation of markers of inflammation to the development of glucose disorders in the elderly: the Cardiovascular Health Study. Diabetes 2001, 50:2384-2389.
• [11]Pradhan AD, Cook NR, Buring JE: C-reactive protein is independently associated with fasting insulin in non diabetic women. Arterioscler Thromb Vasc Biol 2003, 23(4):650-655.
• [12]Visser M, Bouter LM, McQuillan GM: Elevated C-reactive protein levels in overweight and obese adults. JAMA 1998, 282(22):2131-2135.
• [13]Jassal DS, Blair O’N: The Impact of C-Reactive Protein. Perspective in Cardiol 2003, 19(2):30-36.
• [14]Kristiansen OP, Mandrup-Poulsen T: Interleukin-6 and diabetes: the good, the bad, or the indifferent? Diabetes 2005, 54(Suppl 2):S114-124.
• [15]Dubiński A, Zdrojewicz Z: [The role of interleukin-6 in development and progression of atherosclerosis]” (in Polish). Pol Merkur Lekarski 2007, 22(130):291-294.
• [16]Pradhan AD, Manson JE, Rifai N: C-Reactive Protein, Interleukin 6, and Risk of Developing Type 2 Diabetes Mellitus. JAMA 2001, 286(3):327-334.
• [17]Grundy SM, Brewer HB Jr, Cleeman JI: Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation 2004, 109(3):433-438.
• [18]Haffner MS, Gonzalez C, Miettiner H: A prospective analysis of the HOMA model. Diabetes Care 1996, 19:1138-1141.
• [19]Ridker PM: Cardiology Patient Page. C-reactive protein: a simple test to help predict risk of heart attack and stroke. Circulation 2003, 108(12):e81-85.
• [20]Isomaa B, Forsén B, Lahti K: A family history of diabetes is associated with reduced physical fitness in the Prevalence, Prediction and Prevention of Diabetes (PPP)-Botnia study. Diabetologia 2010, 53(8):1709-1713.
• [21]Verma A, Boney CM, Tucker R: Insulin resistance syndrome in women with prior history of gestational diabetes mellitus. J Clin Endocrinol Metab 2002, 87(7):3227-3235.
• [22]Akinci B, Celtik A, Yener S: Prediction of developing metabolic syndrome after gestational diabetes mellitus. Fertil Steril 2010, 93(4):1248-1254.
• [23]Chatzi L, Plana E, Pappas A: The metabolic syndrome in early pregnancy and risk of gestational diabetes mellitus. Diabetes Metab 2009, 35(6):490-494.
• [24]Lauenborg J, Mathiesen E, Hansen T: The prevalence of the metabolic syndrome in a Danish population of women with previous gestational diabetes mellitus is three-fold higher than in the general population. J Clin Endocrinol Metab 2005, 90(7):4004-4010.
• [25]Winzer C, Wagner O, Festa A: Plasma adiponectin, insulin sensitivity, and subclinical inflammation in women with prior gestational diabetes mellitus. Diabetes Care 2004, 27(7):1721-1727.
• [26]Kao TW, Lu IS, Liao KC: Associations between body mass index and serum levels of C-reactive protein. S Afr Med J 2009, 99(5):326-330.
• [27]Retnakaran R, Hanley AG, Raif N: C-reactive protein and gestational diabetes: the central role of maternal obesity. J Clin Endocrinol Metab 2003, 88(8):3507-3512.
• [28]Saltevo J, Vanhala M, Kautiainen H: Levels of adiponectin, C-reactive protein and interleukin-1 receptor antagonist are associated with the relative change in body mass index between childhood and adulthood. Diab Vasc Dis Res 2007, 4(4):328-331.
• [29]King DE, Mainous AG III, Buchanan TA: C-reactive protein and glycemic control in adults with diabetes. Diabetes Care 2003, 26(5):1535-1539.
• [30]Lee AJ, Hiscock RJ, Wein P: Gestational diabetes mellitus: clinical predictors and long-term risk of developing type 2 diabetes: a retrospective cohort study using survival analysis. Diabetes Care 2007, 30(4):878-883.
• [31]Niskanen L, Laaksonen DE, Nyyssönen K: Inflammation, abdominal obesity, and smoking as predictors of hypertension. Hypertension 2004, 44(6):859-865.
• [32]Cartier A: The inflammatory profile associated with abdominal obesity. Official J International Chair on Cardiometabolic Risk 2010, 3(2):15-19.
• [33]Alvehus M, Burén J, Sjöström M: The human visceral fat depot has a unique inflammatory profile. Obesity (Silver Spring) 2010, 18(5):879-883.
• [34]Olszanecka-Glinianowicz M, Zahorska-Markiewicz B: [Obesity as inflammatory disease]. Postepy Hig Med Dosw (Online) 2008, 27; 62:249-257. Review