GDM (gestational diabetes mellitus) is associated with later adverse cardiovascular risk. The present study examined the relationship between glycaemia during pregnancy and small artery function and structures approx. 2 years postpartum. Women were originally enrolled in the HAPO (Hyperglycaemia and Adverse Pregnancy Outcome) study from which they were classified by their glycaemic distribution during pregnancy as controls (in the lower half of the distribution), UQ (upper quartile; in the UQ of the glycaemic distribution) or having had overt GDM. Subcutaneous arteries from a gluteal fat biopsy taken at follow-up 2 years later were examined using wire myography. Small artery structure, stiffness and vasoconstrictor responses were similar across groups. Maximal endothelium-dependent dilation in response to carbachol was impaired in arteries from both GDM (43.3%, n=8 and P=0.01) and UQ (51.7%, n=13 and P=0.04) women despite generally ‘normal’ current glycaemia (controls, 72.7% and n=8). Inhibition of NOS (nitric oxide synthase) significantly reduced maximum endothelium-dependent dilation in controls but had no effect on arteries from UQ and GDM women, suggesting impaired NOS activity in these groups. Endothelium-independent dilation was unaffected in arteries from previous GDM and UQ women when compared with the control group. Multiple regression analysis suggested that BMI (body mass index) at biopsy was the most potent factor independently associated with small artery function, with no effect of current glycaemia. Overweight women with either GDM or marginally raised glycaemia during pregnancy (our UQ group) had normal vascular structure and stiffness, but clearly detectable progressively impaired endothelium-dependent function at 2 years follow-up. These results suggest that vascular pathology, which may still be reversible, is detectable very early in women at risk of decline into Type 2 diabetes mellitus.
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Research Article|
September 20 2011
Small artery function 2 years postpartum in women with altered glycaemic distributions in their preceding pregnancy
Moulinath Banerjee;
Moulinath Banerjee
*Cardiovascular Sciences Research Group, University of Manchester Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, U.K.
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Simon G. Anderson;
Simon G. Anderson
*Cardiovascular Sciences Research Group, University of Manchester Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, U.K.
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Rayaz A. Malik;
Rayaz A. Malik
*Cardiovascular Sciences Research Group, University of Manchester Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, U.K.
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Clare E. Austin;
Clare E. Austin
1
*Cardiovascular Sciences Research Group, University of Manchester Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, U.K.
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J. Kennedy Cruickshank
J. Kennedy Cruickshank
1
*Cardiovascular Sciences Research Group, University of Manchester Core Technology Facility, 46 Grafton Street, Manchester M13 9NT, U.K.
†Diabetes, Nutrition and Cardiovascular Medicine, Franklin-Wilkins Building, King's College London, 150 Stamford Street, London SE1 9NH, U.K.
Correspondence: Professor J. Kennedy Cruickshank (email [email protected]).
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Publisher: Portland Press Ltd
Received:
January 21 2011
Revision Received:
June 27 2011
Accepted:
July 11 2011
Accepted Manuscript online:
July 11 2011
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2012 Biochemical Society
2012
Clin Sci (Lond) (2012) 122 (2): 53–61.
Article history
Received:
January 21 2011
Revision Received:
June 27 2011
Accepted:
July 11 2011
Accepted Manuscript online:
July 11 2011
Citation
Moulinath Banerjee, Simon G. Anderson, Rayaz A. Malik, Clare E. Austin, J. Kennedy Cruickshank; Small artery function 2 years postpartum in women with altered glycaemic distributions in their preceding pregnancy. Clin Sci (Lond) 1 January 2012; 122 (2): 53–61. doi: https://doi.org/10.1042/CS20110033
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