Retinal Vasculature and 5-Year Metabolic Syndrome among Women with Gestational Diabetes Mellitus.

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BACKGROUND

Women 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 womenwith GDM.

METHODS

A 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.

RESULTS

Our 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%.

CONCLUSIONS

Second-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.

Investigators
Abbreviation
Metabolism
Publication Date
2017-10-16
Pubmed ID
29051041
Full Title
Retinal Vasculature and 5-Year Metabolic Syndrome among Women with Gestational Diabetes Mellitus.
Authors
Li LJ, Tan KH, Aris IM, Man REK, Gan ATL, Chong YS, Saw SM, Gluckman P, Wong TY, Lamoureux E