Assessment of noninvasive risk markers of subclinical atherosclerosis in premenopausal women with previous history of gestational diabetes mellitus

Gestational diabetes mellitus [GDM] is state of carbohydrate intolerance detected first time during pregnancy. GDM represents a significant risk factor for the development of CVD in women. The degree to which women with histories of gestational diabetes are at risk for cardiovascular disease, beyond their predisposition to future diabetes, is still unclear. The aim of our study was to assess the presence of surrogate markers of subclinical atherosclerosis which can be present in them even without developing type 2 diabetes. In this descriptive cross-sectional hospital based study, 50 patients 20-45 yrs of age, premenopausal, at least 1 yr past her most recent pregnancy, and not more than 5 yr past her index pregnancy with GDM. These patients and controls who did not have GDM were assessed for carotid intima media thickness,endothelial dysfunction, epicardial fat thickness and other cardiovascular risk factors. Women with pGDM were found to have unfavourable cardiovascular risk parameters. They also demonstrated more frequent occurrence of metabolic syndrome [64% vs 10%] than control subjects. Individual components of MS increased with increasing BMI in both the groups. As far as markers of subclinical atherosclerosis were concerned women with pGDM had significantly higher CIMT, FMD and epicardial fat thickness than control group. Women with pGDM, even before development of diabetes have significant differences in CVD risk factors when compared to those who do not have such history. Postpartum screening for glucose intolerance and efforts to minimize modifiable cardiovascular risk factors, including hypertension, viscerall adiposity, and dyslipidemia should be the most effective measures for lowering of cardiovascular risk

[Association of Angiotensin-Converting Enzyme and Glutathione S-Transferase Gene Polymorphisms with body mass index among Hypertensive North Indians]

Objectives: This study aimed to examine the association of angiotensin-converting enzyme [ACE] and glutathione S-transferase [GST] gene polymorphisms with body mass index [BMI] in hypertensive North Indians

Methods: This case-control study was carried out between May 2013 and November 2014 at the Era's Lucknow Medical College and Hospital, Lucknow, India, and included 378 subjects divided into three groups. One group constituted 253 hypertensive individuals [sustained diastolic blood pressure of >90 mmHg and systolic blood pressure of >140 mmHg] who were subcategorised according to normal [<25 kg/m[2]] or high [>/-25 kg/m[2]] BMI. The third group consisted of 125 age-, gender- and ethnically-matched normotensive controls with a normal BMI. Gene polymorphisms were evaluated by polymerase chain reaction. The genotypic and allelic frequency distribution among both groups were analysed

Results: A significant difference was found between GST theta 1-null and GST mu 1-positive genotype frequencies among the hypertensive overweight/obese individuals and controls [P = 0.014 and 0.033, respectively]. However, no difference was observed in the frequency of ACE polymorphisms. ACE insertion/insertion genotype [P = 0.006], insertion and deletion alleles [P = 0.007 each] and GST theta 1-null and GST theta 1-positive genotypes [P = 0.006 each] were found to differ significantly between hypertensive cases and controls, regardless of BMI

Conclusion: ACE and GST gene polymorphisms were not associated with BMI but were significantly associated with hypertension among the studied group of North Indians