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Original Articles
Carotid Intimal-Medial Thickness Is Not Increased in Women with Previous Gestational Diabetes Mellitus
Yun Hyi Ku, Sung Hee Choi, Soo Lim, Young Min Cho, Young Joo Park, Kyong Soo Park, Seong Yeon Kim, Hak Chul Jang
Diabetes Metab J. 2011;35(5):497-503.   Published online October 31, 2011
DOI: https://doi.org/10.4093/dmj.2011.35.5.497
  • 3,802 View
  • 40 Download
  • 10 Crossref
AbstractAbstract PDFPubReader   
Background

Gestational diabetes mellitus (GDM) is known to increase the risk of cardiovascular diseases. Measuring the carotid artery intimal-medial thickness (CIMT) is a non-invasive technique used to evaluate early atherosclerosis and to predict future cardiovascular diseases. We examined the association between CIMT and cardiovascular risk factors in young Korean women with previous GDM.

Methods

One hundred one women with previous GDM and 19 women who had normal pregnancies (NP) were recruited between 1999 and 2002. At one year postpartum, CIMT was measured using high-resolution B-mode ultrasonography, and oral glucose tolerance tests were performed. Fasting glucose, glycated hemoglobin A1c (HbA1c), insulin levels and lipid profiles were also measured. CIMTs in the GDM and NP groups were compared, and the associations between CIMT and cardiovascular risk factors were analyzed in the GDM group.

Results

CIMT results of the GDM group were not significantly different from those of the NP group (GDM, 0.435±0.054 mm; NP, 0.460±0.046 mm; P=0.069). In the GDM group, a higher HbA1c was associated with an increase in CIMT after age adjustment (P=0.011). CIMT results in the group with HbA1c >6.0% were higher than those of the normal HbA1c (HbA1c ≤6.0%) (P=0.010). Nine of the patients who are type 2 diabetes mellitus converters within one year postpartum but showed no significant difference in CIMT results compared to NP group.

Conclusion

Higher HbA1c is associated with an increase in CIMT in women with previous GDM. However, CIMT at one year postpartum was not increased in these women compared to that in NP women.

Citations

Citations to this article as recorded by  
  • Women with a history of gestational diabetes mellitus present an accumulation of cardiovascular risk factors at age 46—A birth cohort study
    Evi Bakiris, Kaisu Luiro, Jari Jokelainen, Laure Morin‐Papunen, Sirkka Keinänen‐Kiukaanniemi, Kari Kaikkonen, Terhi Piltonen, Juha S. Tapanainen, Juha Auvinen
    Acta Obstetricia et Gynecologica Scandinavica.2024; 103(7): 1318.     CrossRef
  • The effect of gestational diabetes mellitus on carotid artery intima-media thickness in and after pregnancy: a systematic review and meta-analysis
    Andrea Sonaglioni, Elisabetta Piergallini, Angelo Naselli, Gian Luigi Nicolosi, Anna Ferrulli, Stefano Bianchi, Michele Lombardo, Giuseppe Ambrosio
    Acta Diabetologica.2023;[Epub]     CrossRef
  • Prognostic indicators of persistent carotid intima-media thickness increase in postpartum period in a population of normotensive women with gestational diabetes mellitus
    Andrea Sonaglioni, Gian Luigi Nicolosi, Valentina Esposito, Stefano Bianchi, Michele Lombardo
    European Journal of Obstetrics & Gynecology and Reproductive Biology.2022; 269: 47.     CrossRef
  • Pharmacotherapy for gestational diabetes
    Angelo Maria Patti, Rosaria Vincenza Giglio, Kalliopi Pafili, Manfredi Rizzo, Nikolaos Papanas
    Expert Opinion on Pharmacotherapy.2018; 19(13): 1407.     CrossRef
  • Women with a history of gestational diabetes on long-term follow up have normal vascular function despite more dysglycemia, dyslipidemia and adiposity
    Olubukola Ajala, Louise A. Jensen, Edmond Ryan, Constance Chik
    Diabetes Research and Clinical Practice.2015; 110(3): 309.     CrossRef
  • Gestational Diabetes Mellitus in Korean Women: Similarities and Differences from Other Racial/Ethnic Groups
    Catherine Kim
    Diabetes & Metabolism Journal.2014; 38(1): 1.     CrossRef
  • History of Gestational Diabetes Mellitus and Future Risk of Atherosclerosis in Mid‐life: The Coronary Artery Risk Development in Young Adults Study
    Erica P. Gunderson, Vicky Chiang, Mark J. Pletcher, David R. Jacobs, Charles P. Quesenberry, Stephen Sidney, Cora E. Lewis
    Journal of the American Heart Association.2014;[Epub]     CrossRef
  • Association of Gestational Diabetes Mellitus (GDM) with subclinical atherosclerosis: a systemic review and meta-analysis
    Jing-Wei Li, Si-Yi He, Peng Liu, Lin Luo, Liang Zhao, Ying-Bin Xiao
    BMC Cardiovascular Disorders.2014;[Epub]     CrossRef
  • Cardiovascular Disease Risk in the Offspring of Diabetic Women: The Impact of the Intrauterine Environment
    Laura J. Marco, Kate McCloskey, Peter J. Vuillermin, David Burgner, Joanne Said, Anne-Louise Ponsonby
    Experimental Diabetes Research.2012; 2012: 1.     CrossRef
  • The Association between Carotid Atherosclerosis and Glucose
    Bo Kyung Koo
    Diabetes & Metabolism Journal.2011; 35(5): 466.     CrossRef
Is A1C Variability an Independent Predictor for the Progression of Atherosclerosis in Type 2 Diabetic Patients?
Chul Sik Kim, So Young Park, Sung Hoon Yu, Jun Goo Kang, Ohk Hyun Ryu, Seong Jin Lee, Eun Gyung Hong, Hyeon Kyu Kim, Doo-Man Kim, Jae Myung Yoo, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo
Korean Diabetes J. 2010;34(3):174-181.   Published online June 30, 2010
DOI: https://doi.org/10.4093/kdj.2010.34.3.174
  • 4,476 View
  • 29 Download
  • 9 Crossref
AbstractAbstract PDFPubReader   
Background

Little is known about the relative contribution of long-term glycemic variability to the risk of macrovascular complications in type 2 diabetes. This study was conducted to evaluate the effect of A1C variability on the progression of carotid artery intima-media thickness (IMT) in type 2 diabetic patients.

Methods

Among type 2 diabetic patients who visited Hallym University Sacred Heart Hospital from March 2007 to September 2009, 120 patients who had carotid artery IMT measured annually and A1C checked every three months for at least one year were analyzed. Individual A1C variability was defined as the standard deviation (SD) of five A1C levels taken every three months for approximately one year. Change in IMT was defined as an increase in IMT on follow-up measurement. The association between the SD of A1C and changes in IMT was evaluated.

Results

With greater A1C variability, there was a greater increase in the mean IMT (r = 0.350, P < 0.001) of the carotid artery. After adjusting for confounding factors that may influence IMT, A1C variability was significantly associated with the progression of IMT (r = 0.222, P = 0.034). However, the SD of A1C was not a significant independent risk factor for the progression of IMT in multiple regression analysis (β = 0.158, P = 0.093).

Conclusion

Higher A1C variability is associated with IMT progression in type 2 diabetic patients; however, it is not an independent predictor of IMT progression. Overall glycemic control is the most important factor in the progression of IMT.

Citations

Citations to this article as recorded by  
  • Long-Term Risk of Cardiovascular Disease Among Type 2 Diabetes Patients According to Average and Visit-to-Visit Variations of HbA1c Levels During the First 3 Years of Diabetes Diagnosis
    Hyunah Kim, Da Young Jung, Seung-Hwan Lee, Jae-Hyoung Cho, Hyeon Woo Yim, Hun-Sung Kim
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Association Between Long-Term Visit-to-Visit Hemoglobin A1c and Cardiovascular Risk in Type 2 Diabetes: The ACCORD Trial
    Dan Huang, Yong-Quan Huang, Qun-Ying Zhang, Yan Cui, Tian-Yi Mu, Yin Huang
    Frontiers in Cardiovascular Medicine.2021;[Epub]     CrossRef
  • Association of Longitudinal Values of Glycated Hemoglobin With Cardiovascular Events in Patients With Type 2 Diabetes and Multivessel Coronary Artery Disease
    Paulo Cury Rezende, Mark Andrew Hlatky, Whady Hueb, Rosa Maria Rahmi Garcia, Luciano da Silva Selistre, Eduardo Gomes Lima, Cibele Larrosa Garzillo, Thiago Luis Scudeler, Gustavo Andre Boeing Boros, Fernando Faglioni Ribas, Carlos Vicente Serrano, Jose An
    JAMA Network Open.2020; 3(1): e1919666.     CrossRef
  • Haemoglobin A1c variability as an independent correlate of atherosclerosis and cardiovascular disease in Chinese type 2 diabetes
    Yifei Mo, Jian Zhou, Xiaojing Ma, Wei Zhu, Lei Zhang, Jie Li, Jingyi Lu, Cheng Hu, Yuqian Bao, Weiping Jia
    Diabetes and Vascular Disease Research.2018; 15(5): 402.     CrossRef
  • Relationship of HbA1c variability, absolute changes in HbA1c, and all-cause mortality in type 2 diabetes: a Danish population-based prospective observational study
    Mette V Skriver, Annelli Sandbæk, Jette K Kristensen, Henrik Støvring
    BMJ Open Diabetes Research & Care.2015; 3(1): e000060.     CrossRef
  • Association between hemoglobin A1c variability and subclinical coronary atherosclerosis in subjects with type 2 diabetes
    Hae Kyung Yang, Borami Kang, Seung-Hwan Lee, Kun-Ho Yoon, Byung-Hee Hwang, Kiyuk Chang, Kyungdo Han, Gunseog Kang, Jae Hyoung Cho
    Journal of Diabetes and its Complications.2015; 29(6): 776.     CrossRef
  • Glycated hemoglobin as a marker of subclinical atherosclerosis and cardiac remodeling among non-diabetic adults from the general population
    Robin Haring, Sebastian E. Baumeister, Wolfgang Lieb, Bettina von Sarnowski, Henry Völzke, Stephan B. Felix, Matthias Nauck, Henri Wallaschofski
    Diabetes Research and Clinical Practice.2014; 105(3): 416.     CrossRef
  • HbA1c Variability and Micro- and Macrovascular Complications of Diabetes
    Hae Kyung Yang, Seung-Hwan Lee
    The Journal of Korean Diabetes.2014; 15(4): 202.     CrossRef
  • HbA1c variability and the development of microalbuminuria in type 2 diabetes: Tsukuba Kawai Diabetes Registry 2
    A. Sugawara, K. Kawai, S. Motohashi, K. Saito, S. Kodama, Y. Yachi, R. Hirasawa, H. Shimano, K. Yamazaki, H. Sone
    Diabetologia.2012; 55(8): 2128.     CrossRef
Randomized Controlled Trial
Relationship between Carotid Atherosclerosis and Chlamydia Pneumoniae Seropositivity in Type 2 Diabetes.
Su Jin Jung, Ji Hye Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Baek
Korean Diabetes J. 2005;29(4):352-357.   Published online July 1, 2005
  • 1,205 View
  • 16 Download
AbstractAbstract PDF
BACKGROUND
The major causes of death in diabetic patients are atherosclerosis-related diseases. Infection with Chlamydia pneumoniae(C. pneumoniae) has been reported to play a pathogenic role in atherosclerosis. However, data relating to C. pneumoniae exposure are rare in type 2 diabetes that are more susceptible to infection. The aim of this study was to see whether C. pneumoniae seropositivity was associated with carotid atherosclerosis in type 2 diabetic patients. METHODS: The subjects of this study were 135 type 2 diabetic patients. Serum samples from the subjects were assayed for risk factors, including lipid profiles, HbA1c, fibrinogen and CRP. Serum titers of antibodies to C. pneumoniae(IgG, IgM) were measured using microimmunofluorescence(MIF). tests Carotid ultrasound examination was used to measure the intima-media thickness(IMT), plaques and the presence of stenosis in each segment of both carotid arteries. RESULTS: C. pneumoniae seropositivity was detected in 17.8%(n=24), but without any difference between the sexes, in the 135 type 2 diabetic patients. The CRP level was increased in the seropositive group(P=0.041). The presence of carotid stenosis and IMT were significantly from a associated with C. pneumoniae seropositivity from a univariate analysis(IMTmean: IgG(+), 0.93mm vs. IgG(-), 0.85mm, P = 0.038, IMTmax: IgG(+), 1.29mm vs. IgG(-), 1.17mm, P = 0.025, stenosis: IgG (+), 25% vs. IgG(-) 7.2%, P = 0.020). No association was found for the plaque count or score. After controlling for cardiovascular risk factors, including age, sex, hypertension, cholesterol, and CRP, the association of C. pneumonia seropositivity with the IMTmean or carotid stenosis remained significant(IMTmean: P = 0.027, stenosis: P = 0.026). CONCLUSIONS: Serologic evidence of C. pneumoniae infection was detected in 17.8% randomly-assigned type 2 diabetic patients. C. pneumoniae seropositivity may be a risk factor for carotid atherosclerosis in type 2 diabetic patients.
Original Article
Plasma Fibrinogen Level is Associated with Carotid Plaque Progression in Type 2 Diabetic Patients.
Seong Hun Kim, Ji Hye Kim, Chong Hwa Kim, Ji Hyun Park, Tae Sun Park, Hong Sun Back
Korean Diabetes J. 2004;28(4):293-303.   Published online August 1, 2004
  • 1,102 View
  • 18 Download
AbstractAbstract PDF
BACKGROUND
The level of plasma fibrinogen has emerged as an important risk factor for cardiovascular diseases. Raised fibrinogen levels result in enhanced fibrin deposition in areas of vessel wall injury, which in turn may accelerate the development of atherosclerotic disease. The aim of present study was to investigate whether the plasma fibrinogen levels was related to carotid atherosclerosis in type 2 diabetic patients. METHODS: The sbjects of this study were 210 type 2 diabetic patients. The intima-media thickness (IMT) and plaques in the each segment of the both carotid arteries were evaluated by a duplex scan. The mean of the total IMT values (7 points on each side), the each mean value of the CCA, bulb and ICA, and the maximal IMT, plaque count and score were measured. The plaque score was defined by the sum of longitudinal diameters of each plaque. RESULTS: The correlation between the plasma fibrinogen level and measured IMT values was statistically insignificant (r<0.15, P>0.05). However, there were significant positive correlations between the level of fibrinogen and the plaque count (r=0.20, P=0.019) or plaque score (r=0.24, P=0.006). Stepwise multiple regression analysis revealed the level of plasma fibrinogen as a predictor of the plaque score. CONCLUSION: These results suggest that an elevated plasma fibrinogen level may be related with carotid atherosclerosis in type 2 diabetic patients. Also, there a need to address the discriminating risk factors for the formation or progression of plaques, or IMT thickening.

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