Research Paper

Vascular Function in Women with Previous Gestational Diabetes mellitus
Michael M. Hannemann^a, William G. Liddell^a, Angela C. Shore^a, Penny M. Clark^b, John E. Tooke<sup>a

a</sup>Institute of Biomedical Research, Peninsula Medical School, Exeter, and
^bRegional Endocrine Laboratory, University Hospital, Birmingham NHS Trust, Birmingham, UK

Address of Corresponding Author

J Vasc Res 2002;39:311-319 (DOI: 10.1159/000065543)

  Key Words

• Gestational diabetes mellitus
• Type 2 diabetes mellitus
• Vascular endothelium
• Insulin resistance
• Maximum microvascular hyperaemia
• Iontophoresis
• Flow-related vasodilatation

  Abstract

It is hypothesised that vascular dysfunction, which characterises type 2 diabetes, may predate development of hyperglycaemia. 17 women with previous gestational diabetes mellitus, and thus at risk of developing type 2 diabetes, were matched with normal controls for body mass index, menstrual phase, smoking, age, blood pressure, and lipid profiles. All had normal glucose tolerance. Tests of microvascular and macrovascular function, including endothelium-dependent and -independent vasodilatation, were performed. Laser Doppler fluximetry of maximum skin microvascular hyperaemia in response to local heating of the dorsum of the foot to 42°C for 30 min was impaired in subjects compared to controls [subjects = 1.15 (0.73-1.73) V median (range) versus controls = 1.50 (0.95-2.29) V, p = 0.008]. There were no differences in laser Doppler perfusion imaging of responses to forearm skin iontophoresis of acetylcholine [subjects = 1.59 (0.32-2.55) V median (range) versus controls = 1.79 (0.72-2.06) V; p = 0.81] and sodium nitroprusside [subjects = 1.39 (0.8-3.14) V versus controls = 1.41 (0.34-2.19) V; p = 0.68], ultrasound estimation of brachial artery flow-mediated dilatation [subjects = 1.65 (-0.5-9.07)% versus controls = 2.77 (0.63-6.6)%; p = 0.42] and glyceryl trinitrate-induced dilatation [subjects = 15.20 (6.64-20.91)% versus controls = 15.92 (3.94-22.09)%; p = 0.48]. Microvascular maximum hyperaemia was impaired in the index group, suggesting the presence of a defect in vascular function. This defect was not explained by those aspects of endothelial function measured by the other techniques.

Copyright © 2002 S. Karger AG, Basel

  Author Contacts

Dr. M.M. Hannemann
Centre for Clinical Microvascular Research, Institute of Biomedical Research
Peninsula Medical School
Barrack Road, Exeter, EX2 5AX (UK)
Tel. +44 1392 403081, Fax +44 1392 403027, E-Mail M.M.Hannemann@exeter.ac.uk

  Article Information

Received: Received: May 28, 2001
Accepted after revision: January 25, 2002
Number of Print Pages : 9
Number of Figures : 6, Number of Tables : 1, Number of References : 55