Clinical Value of Echo-Tracking in Gestational Diabetes Mellitus.

BACKGROUND: Vascular endothelial function plays an essential role in gestational diabetes mellitus (GDM) pathogenesis. Vascular elasticity is evaluated by the echo-tracking (ET) technique. In this study, we aimed to assess the clinical value of the ET technique in women with GDM and provide a basis for early evaluation and prevention of gestational diabetes. METHODS: Sixty-five patients with GDM and 65 gestational week-matched normal glucose tolerance pregnant women were enrolled in this study. The endothelial function parameters of pressure-strain elasticity coefficient (EP), the common carotid stiffness index (ß), arterial compliance (AC), single-point pulsed-wave velocity (PWVß), and augment index (AI) of bilateral common carotid arteries, were compared between the GDM and control groups by using ET technique. The correlations between plasma glucose levels and ET parameters were also analyzed. RESULTS: Our results indicated that EP, ß, PWVß, and AI were significantly higher in the GDM group (p<0.05), whereas AC was significantly lower in patients with GDM than in the control group (p<0.001). In addition, fasting plasma glucose and plasma glucose level after 2 h oral glucose tolerance test was correlated with ET parameters of EP, ß, PWVß, AI, and AC. CONCLUSIONS: The application of ET technology to gestational diabetes women could provide a basis for early evaluation and prevention of gestational diabetes. It would detect early and accurate signs of diabetes in pregnant women and provide a timely and reasonable clinical treatment plan to reduce and delay the occurrence of complications.

Vascular endothelial dysfunction in gestational diabetes mellitus.

BACKGROUND: Gestational diabetes mellitus (GDM) is a common pregnancy-related disorder that pregnant women without diabetes develop glucose tolerance during pregnancy. Endothelial dysfunction is the early event of vascular complications of diabetes. However, the role of endothelial dysfunction in GDM remains unknown. In this study, we hypothesize that there is a correlation between endothelial dysfunction and GDM indexes in the patients. METHODS: 96 GDM patients and 96 gestational week-matched healthy pregnancies with normal glucose tolerance were recruited in our study. The expressions of endothelial function markers, including nitride oxidase (NO) and endothelin-1 (ET-1), as well as flow-mediated dilatation (FMD), were measured. In addition, their correlation in GDM patients were also analyzed using Pearson's correlation analysis. RESULTS: GDM patients displayed decrease on FMD and serum NO levels with an increase on serum ET-1 secretion in comparison with normal glucose tolerance group. ROC analysis identified the predictive value of FMD, ET-1 and NO for GDM. Furthermore, endothelial dysfunction was correlated with both fasting plasma glucose and plasma glucose levels after 1 h or 2 h of oral glucose tolerance test in GDM patients. CONCLUSION: Our data indicated that endothelial dysfunction was associated with GDM, and these markers might serve as potential biomarkers for GDM.