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INTRODUTION

INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES. L.Ruas 1 , S.Paiva 1 ,I.Marques 3 , A. Palmeiro 3 , E.Marta 2 , A. Lobo 2 , E.Sobral 2 , M.Carvalheiro 1 1 Department of Endocrinology; 2 Department of Obstetrics; 3 Department of Pathology.

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INTRODUTION

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  1. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES L.Ruas1, S.Paiva1,I.Marques3, A. Palmeiro3, E.Marta2, A. Lobo2, E.Sobral2, M.Carvalheiro1 1Department of Endocrinology; 2Department of Obstetrics; 3Department of Pathology

  2. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES INTRODUTION Women with previous gestational diabetes (pGDM) may be considered at risk for cardiovascular (CV) disease later in life. This can be highlighted in several clinical, biochemical parameters, namely hemostatic and inflammatory markers.

  3. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES PATIENTS AND METHODS 10 pGDM women- 40 ± 5.1 yrs - Time since pGDM: 7.9 ± 0.3 yrs Clinical parameters - BMI, BP (blood pressure), WHR (waist hip ratio) Biochemical parameters - OGTT (75 g glucose), total, HDL and LDL cholesterol, triglyceride (TG), fasting insulinemia - Inflammatory and hemostatic markers: fibrinogen, coagulating factor VIII, von Willebrand factor, high sensitive C-reactive protein (CRP), PAI-1, homocysteine (Hcy) -Thrombotic risk genotype: Factor V Leiden; Protrombine G20210A, MTHFR (methylene tetrahydrofolate redutase), PAI-1 4G/5G - VCAM(soluble vascular cell adhesion molecule) -ICAM(soluble intercellular adhesion molecule)

  4. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES Subject Characteristics : * Patients with Abnormal Glucose tolerance

  5. Metabolic characteristics : INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES N:<30 0.8- 4 * Patients with Abnormal Glucose tolerance

  6. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES N:2-5 80-120 4-43 <0.5 5-15 * Patients with Abnormal Glucose iolerance

  7. Characteristics of the population with NGT and AGT: INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS

  8. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES Adhesion molecule levels in women with Abnormal (AGT) and normal (NGT) glucose tolerance

  9. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES PAI-1 levels in women with abnormal (AGT) and normal (NGT) glucose tolerance

  10. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES Correlation of PAI-1 Activity with BMI p =0.004 r= 0.81

  11. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES Correlation of PAI-1 Activity with C.peptide p= 0.029 r=0.68

  12. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES Polymorphisms of Coagulation Factor Genes * Patients with Abnormal Glucose tolerance

  13. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES MTHFR mutation and Homocysteine levels: 5-15 1-20 * Patients with Abnormal Glucose tolerance

  14. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES PAI-1 polymorphisms and PAI-1levels: * Patients with Abnormal Glucose tolerance

  15. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES CORRELATIONS OF POLYMORPHISMS OF THE PAI-1 GENE WITH BIOLOGYCAL AND ANTHROPOMETRIC PARAMETERS

  16. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES DISCUSSION There was a high prevalence of abnormal glucose tolerance (60%) among this pGDM women. In the abnormal glucose tolerance (AGT) group we found: - high levels of PAI-1, VCAM, ICAM, - high BMI and BP, - high values of HOMA. The genotype subtype 4G/5G of the PAI-1 gene was the most frequent in our population (70%) and was related with high levels of PAI-1. PAI-1 levels were correlated with variables of the IR syndrome (BMI, C pep.). Women with MTHFR mutation ( VAL/VAL) presented the highest homocysteine levels.

  17. INFLAMMATORY AND HEMOSTATIC MARKERS OF CARDIOVASCULAR RISK IN WOMEN WITH PREVIOUS GESTATIONAL DIABETES In the sub- group of women with pGDM and abnormal glucose tolerance (AGT) we found biomarkers of endothelial dysfuntion, inflammatory and hemostatic markers that are associated with CV risk. These women should be followed, and all metabolic alterations and lifestyle risk factors for CV disease should be eliminated. The presence of inflammatory and hemostatic markers of endothelial dysfunction can, in the future , be used as a predictor of cardiovascular disease ( primary prevention).

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