Retinal vasculature and 5-year metabolic syndrome among women with gestational diabetes mellitus |
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| Affiliation: | 1. Singapore Eye Research Institute, Singapore National Eye Centre, Singapore;2. Duke-NUS Medical School, Singapore;3. KK Women''s and Children''s Hospital, Singapore;4. Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore;5. Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore;6. Singapore Institute for Clinical Sciences, Growth, Development & Metabolism, Singapore;1. First Department of Pharmacology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece;2. Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy;2. Division of Cardiology, Istituti Clinici Scientifici Maugeri, IRCCS, Veruno, Italy;3. ANMCO Research Center, Florence, Italy;4. Department of Cardiology, Santa Maria degli Angeli Hospital, Pordenone, Italy;5. Therapeutic Science and Strategy Unit (TSSU), IQVIA, Milan, Italy;6. Department of Cardiovascular Research, IRCCS-Istituto di Ricerche Famacologiche Mario Negri, Milan, Italy;7. Division of Cardiology, Ospedale Valdichiana Santa Margherita, Cortona, Italy;8. Maria Cecilia Hospital, GVM Care & Research, Ettore Sansavini Health Science Foundation, Cotignola, Italy;1. Guangdong Province Key Laboratory of Animal Nutritional Regulation, 483 Wushan Road, Tianhe District, Guangzhou, Guangdong 510642, China;2. National Engineering Research Center for Breeding Swine Industry, College of Animal Science, South China Agricultural University, 483 Wushan Road, Tianhe District, Guangzhou, Guangdong 510642, China;3. Brown Foundation Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, 7000 Fannin, Suite 1800, Houston, TX 77030, USA;4. Department of Molecular and Cellular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA;1. Department of Endocrinology & Metabolism, Charite – Universitätsmedizin Berlin, Germany;2. Charité-Center for Cardiovascular Research (CCR), Berlin, Germany;3. Clinical Research Unit, Berlin Institute of Health (BIH);4. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Germany;5. Department of Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin Berlin, Germany;1. Laboratory of Cardiovascular Medicine, Tokyo University of Pharmacy and Life Sciences, Tokyo 192-0392, Japan;2. Division of Diabetes, Metabolism, and Endocrinology, Department of Medicine, Showa University School of Medicine, Tokyo 142-8666, Japan |
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| Abstract: | BackgroundWomen with gestational diabetes mellitus (GDM) are at greater risk of metabolic syndrome (MetS). We studied the association between second-trimester retinal microvasculature and 5-year MetS incidence in women with GDM.MethodsA total of 142 mothers with GDM were recruited and followed up 5 years after delivery. Retinal photography was performed at 26–28 weeks gestation and metabolic outcomes were assessed at the 5-year postpartum follow-up visit. GDM and MetS were defined based on World Health Organization (WHO) guidelines and Adults Treatment Panel (ATP) III guidelines, respectively. Modified-Poisson regression was applied to study the association between second-trimester retinal microvasculature and incident 5-year maternal MetS, after adjusting for major confounders. Area under the curve (AUC) was calculated based on the final model.ResultsOur prospective cohort reported a 9.2% incidence rate of 5-year MetS among women with GDM. After adjusting for maternal age, ethnicity, college degree, pre-pregnancy BMI and fasting glucose at 26–28 week gestation, each 10 μm widening in retinal venular caliber was associated with an increased relative risk of 1.6 (95% confidence interval [CI]: 1.0, 2.8) in incident MetS. In addition to traditional risks of pre-pregnancy BMI and fasting glucose level at 26–28 week gestation, retinal venular caliber mildly increased the prediction of 5-year maternal MetS by 1.8%.ConclusionsSecond-trimester retinal venular widening was associated with incident 5-year maternal MetS in women with GDM. Our study suggests that mother with GDM at risk of future MetS development may have already presented retinal microvascular abnormalities during pregnancy. |
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