Risk Factors for Progression to Postpartum Diabetes Mellitus and Perinatal Complications in Women with Gestational Diabetes Mellitus.

Kim,  Su Jeong; Chun,  Hyunji; Jang,  Eun Hee; Lee,  Joune Seup; Kim,  Meekyoung; Baek,  Ki Hyun; Song,  Ki Ho; Kwon,  Hyuk Sang

doi:2014.15.2.116

J Korean Diabetes > Volume 15(2); 2014 > Article

Original Article

The Journal of Korean Diabetes 2014;15(2):116-123.
DOI: https://doi.org/10.4093/jkd.2014.15.2.116 Published online June 25, 2014.

임신성 당뇨병에서 분만 후 당대사와 주산기 합병증에 영향을 미치는 인자

김수정, 전현지, 장은희, 이준섭, 김미경, 백기현, 송기호, 권혁상

Risk Factors for Progression to Postpartum Diabetes Mellitus and Perinatal Complications in Women with Gestational Diabetes Mellitus.

Su Jeong Kim, Hyunji Chun, Eun Hee Jang, Joune Seup Lee, Meekyoung Kim, Ki Hyun Baek, Ki Ho Song, Hyuk Sang Kwon

¹Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea. hjchun47@gmail.com
²Department of Internal Medicine, Hando Hospital, Ansan, Korea.

Abstract

BACKGROUND
Gestational diabetes mellitus (GDM) is a hyperglycemic condition caused by increased insulin resistance and impaired insulin secretion during pregnancy. It is known to be temporary, but it can cause perinatal complications in the mother and baby. Additionally, it may progress to type 2 diabetes mellitus (T2DM). In the present study, we evaluated the risk factors for complications and progression to T2DM in patients with GDM. METHODS: The study included 130 pregnant women who were diagnosed with GDM at gestational weeks 24-28 in 2011. Body mass index and the levels of glucose, total cholesterol, lipoproteins, and coagulation factors (von Willebrand factor and plasminogen activator inhibitor-1) were assessed in all patients. RESULTS: The level of high-density lipoprotein (HDL) was significantly lower and the triglyceride/HDL ratio and coagulation factor levels were significantly higher in the group of patients with perinatal complications compared to those in the group of patients without complications. After delivery, the level of HDL was lower and the value of homeostasis model assessment of insulin resistance (HOMA-IR) was higher in women with impaired glucose metabolism compared to those in women with normal glucose metabolism. In logistic regression analysis, perinatal complications were independently associated with HDL and PAI-1 levels (OR = 0.929 and 1.101, respectively). CONCLUSION: The findings of our study show that the levels of HDL and coagulation factors are notable risk factors of perinatal complications. Additionally, we showed that lower HDL level may influence the progression to T2DM. Large-scale population studies are needed to verify our findings.

Key Words: Gestational diabetes mellitus, Risk factors, High-density lipoproteins, von Willebrand factor, Plasminogen activator inhibitor 1