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The Influence of Lipid and Proinflammatory Status on Maternal Uterine Blood Flow in Women With Late Onset Gestational Diabetes

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Abstract

Background

Gestational diabetes mellitus (GDM) is associated with increased proinflammatory cytokines and is also associated with adverse cardiovascular disease (CVD) outcomes later in life. We aim to evaluate the relationships between uterine arteries vascularization and endothelial dysfunction markers, proinflammatory cytokines, and glycemic and lipid profile in women with GDM.

Methods

Fifty pregnant women were recruited at the third trimester of pregnancy for a prospective cohort study. They were classified into 2 groups: control and GDM. Comparisons of maternal plasma concentrations of endothelial dysfunction markers (vascular cell adhesion molecule 1, intercellular adhesion molecule 1, and plasminogen activator inhibitor 1), proinflammatory cytokines and mediators (interleukin 6 [IL-6], tumor necrosis factor α, vascular endothelial growth factor, placental growth factor, leptin, leukocyte count, and C-reactive protein), lipid profile, glucose, and glycosylated hemoglobin levels were performed. Mean uterine arteries Doppler pulsatility index (PI) was calculated and the relationships between the variables and PI were also analyzed.

Results

Women with GDM showed higher proinflammatory cytokines, however, endothelial dysfunction markers were similar in both groups. In the diabetic group, significant correlations were found between the mean uterine arteries PI and maternal IL-6 (r =.56, P =.01), triglycerides (r =.49; P =.03), total cholesterol/high-density lipoprotein cholesterol (HDLc) ratio (r =.61; P=.006), glucose (r =.62, P=.005), and glycosylated hemoglobin (r =.48; P=.03). A negative significant correlation between mean uterine arteries PI and HDLc (r =−.58; P=.02) was also found.

Conclusion

The proinflammatory status, hyperlipidemia, and metabolic control correlate with uterine blood flow velocity waveforms in women with gestational diabetes.

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Authors and Affiliations

  1. Division of Fetal-Maternal Medicine, Department of Obstetrics and Gynecology, “Puerta del Mar” University Hospital, Avda Ana de Viya, 21, 11009, Cádiz, Spain

    Fernando Bugatto MD, PhD, José M. Vilar-Sánchez MD, PhD, Alejandro Figueroa-Quiñones MD & Rafael Torrejón MD, PhD

  2. Clinicas Ginemed, Sevilla, Spain

    Rocío Quintero-Prado MD, PhD

  3. Department of Obstetrics and Gynecology, “Hospital de Jerez” University Hospital, Jerez de la Frontera, Cádiz, Spain

    Rocío Quintero-Prado MD, PhD

  4. Research Unit, “Puerta del Mar” University Hospital, Cádiz, Spain

    Francisco M. Visiedo PhD

  5. Department of Endocrinology and Nutrition, “Puerta del Mar” University Hospital, Cadiz, Spain

    Cristina López-Tinoco MD, PhD

  6. Division of Fetal-Maternal Medicine, Department of Obstetrics, “La Paz” University Hospital, Madrid, Spain

    José L. Bartha MD, PhD

Authors
  1. Fernando Bugatto MD, PhD
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  2. Rocío Quintero-Prado MD, PhD
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  3. Francisco M. Visiedo PhD
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  4. José M. Vilar-Sánchez MD, PhD
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  5. Alejandro Figueroa-Quiñones MD
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  6. Cristina López-Tinoco MD, PhD
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  7. Rafael Torrejón MD, PhD
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  8. José L. Bartha MD, PhD
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Corresponding author

Correspondence to Fernando Bugatto MD, PhD.

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Bugatto, F., Quintero-Prado, R., Visiedo, F.M. et al. The Influence of Lipid and Proinflammatory Status on Maternal Uterine Blood Flow in Women With Late Onset Gestational Diabetes. Reprod. Sci. 25, 837–843 (2018). https://doi.org/10.1177/1933719117698576

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  • DOI: https://doi.org/10.1177/1933719117698576

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