Sokup Alina, Ruszkowska Barbara, Góralczyk Krzysztof, Góralczyk Barbara, Grabiec Marek and Rość Danuta
Women with previous gestational diabetes (pGDM) represent a high risk group for type 2 diabetes and for cardiovascular disease in the future. The aim of current study was to assess selected parameters of dysfunction of endothelium such as concentration of soluble E-selectin (sE-selectin), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intracellular adhesion molecule-1 (sICAM-1) in women with pGDM. Subjects/Methods: Anthropometric parameters, glucose regulation, insulin resistance, lipid levels, inflammation and soluble plasma endothelial dysfunction. Biomarkers levels were evaluated in 85 women with pGDM and in the control group of 40 patients 2-24 months postpartum. Results: The pGDM group consisted of 67% women with normal glucose regulation (pGDM-N) and 33% with pre-diabetic state (pGDM-P). The body mass index, waist circumference, fasting and 2-h glucose during oral glucose tolerance test, sVCAM-1, sICAM-1, sE-selectin, tissue plasminogen activator antigen (tPA:Ag), high sensitivity C-reactive protein (hsCRP), total-, LDL-cholesterol and triglycerides/HDL-cholesterol ratio were higher in pGDM women compared with the controls. The pGDM-P group was characterized by higher triglycerides levels compared with the pGDM-N. In the pGDM group only the plasma level of sE-selectin was associated with high glucose concentration within the pre-diabetic range. sE-selectin level correlated with triglycerides, triglycerides/HDL-cholesterol ratio, plasminogen activator inhibitor-1 antigen (PAI-1:Ag) and sICAM-1. In stepwise models of logistic regression analysis, sE-selectin was associated with high levels of glucose independently of age, BMI, PAI-1: Ag and of hsCRP. This association was eliminated after adjustment for triglyceride level. Conclusions: In non-diabetic women with pGDM higher plasma sE-selectin level is not independently associated with the higher risk of pre- diabetic state. We suggest that in the case of these women the higher plasma sE-selectin level is rather the marker of early cardiometabolic risk due to its association with parameters of insulin resistance.
