Association of gestational diabetes mellitus (GDM) with subclinical atherosclerosis: a systemic review and meta-analysis

BMC Cardiovasc Disord. 2014 Sep 29:14:132. doi: 10.1186/1471-2261-14-132.

Abstract

Background: Gestational diabetes mellitus (GDM) is associated with an elevated risk of adverse health outcomes such as type 2 diabetes and cardiovascular diseases. Carotid intima-media thickness (cIMT) is increasingly used as a noninvasive marker for subclinical atherosclerosis. Whether there is a direct correlation between GDM and elevated cIMT is still controversial.

Methods: PubMed, Embase and reference lists of relevant papers were reviewed. Studies assessing the relationship between GDM and cIMT were included. Weighted Mean Difference (WMD) of cIMT was calculated using random-effect models.

Results: Fifteen studies with a total of 2247 subjects were included in our analysis, giving a pooled WMD of 0.05 (95% confidence interval [CI] 0.03 -0.07). Furthermore, meta regression and subgroup analysis found that the association between GDM and larger cIMT already existed during pregnancy, and this relation was stronger in obese GDM patients.

Conclusions: GDM in and after pregnancy is associated with subclinical atherosclerosis. Weight control may be helpful to prevent cardiovascular diseases for GDM patients.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Asymptomatic Diseases
  • Carotid Artery Diseases / diagnosis
  • Carotid Artery Diseases / etiology*
  • Carotid Artery Diseases / physiopathology
  • Carotid Artery Diseases / prevention & control
  • Carotid Intima-Media Thickness
  • Diabetes, Gestational* / diagnosis
  • Diabetes, Gestational* / physiopathology
  • Diabetes, Gestational* / therapy
  • Female
  • Humans
  • Insulin Resistance
  • Obesity / complications
  • Predictive Value of Tests
  • Pregnancy
  • Prognosis
  • Risk Assessment
  • Risk Factors