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Mount Sinai researcher discovers glucose intolerance in pregnancy is associated with postpartum cardiovascular risk

December 1, 2009 — Women who have glucose intolerance, which is less severe than gestational diabetes, in pregnancy exhibit multiple cardiovascular risk factors as early as three months after birth, according to a new study accepted for publication in the Journal of Clinical Endocrinology & Metabolism (JCEM).

Gestational diabetes is known to be associated with an increased risk of developing type 2 diabetes and cardiovascular disease. The metabolic syndrome, defined as the clustering of several cardio-metabolic risk factors including obesity, hypertension and low HDL cholesterol, also identifies patients at risk for developing type 2 diabetes and cardiovascular disease. Researchers in this study sought to evaluate the relationship between gestational glucose intolerance and postpartum risk of metabolic syndrome.

This study followed 487 women who underwent oral glucose tolerance testing during pregnancy. Each subject was classified as either having gestational diabetes, gestational impaired glucose tolerance or normal glucose tolerance. At three months postpartum, researchers evaluated each subject’s cardio-metabolic characteristics, such as blood pressure, weight, waist measurement and lipid levels.

Researchers found that even mild glucose intolerance during pregnancy predicts an increased likelihood of the metabolic syndrome at three-months postpartum. The presence of cardiovascular risk factors as early as three months postpartum suggests that these risk factors are likely chronic and longstanding, and may contribute to the long-term risk of cardiovascular disease in this patient population

“The study findings raise the important possibility that women with gestational glucose intolerance and subsequent postpartum metabolic syndrome may represent a patient population at particularly high risk for the future development of metabolic and vascular disease,“ said Dr. Ravi Retnakaran, Endocrinologist and Clinician Scientist, Leadership Sinai Diabetes Centre, Mount Sinai Hospital and Assistant Professor, the University of Toronto and lead author of the study. ”Further research with long-term follow-up is needed to address this possibility.”

“Our data also suggests that glucose tolerance screening in pregnancy, as is currently practiced, may provide previously unrecognized insight into a woman’s postpartum cardiovascular risk-factor profile,” said Retnakaran. “Furthermore, glucose tolerance screening may identify subgroups of young women for whom cardiovascular risk factor monitoring may be warranted.”

Other researchers working on the study include Ying Qi, Dr. Bernard Zinman and Dr. Mathew Sermer of Mount Sinai Hospital in Toronto, Canada; and Anthony Hanley and Philip Connelly of the University of Toronto in Canada.

The article, “Glucose Intolerance in Pregnancy and Postpartum Risk of Metabolic Syndrome in Young Women,” will appear in the February 2010 issue of JCEM.

About Mount Sinai Hospital

Mount Sinai Hospital is an internationally recognized, 472-bed acute care academic health sciences centre affiliated with the University of Toronto. It is known for excellence in the provision of compassionate patient care, innovative education, and leading-edge research. Mount Sinai’s Centres of Excellence include Women's and Infants' Health; Surgery and Oncology; Acute and Chronic Medicine; Laboratory Medicine and Infection Control, and the Samuel Lunenfeld Research Institute.

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Melissa McDermott
Mount Sinai Hospital
416-586-4800 ext. 8306