Association of gestational diabetes mellitus with left ventricular structure and function: The CARDIA study

Duke Appiah, Pamela J. Schreiner, Erica P. Gunderson, Suma H. Konety, David R. Jacobs, Chike C. Nwabuo, Imo A. Ebong, Hilary K. Whitham, David C. Goff, Joao A. Lima, Ivy A. Ku, Samuel S. Gidding

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

OBJECTIVE Gestational diabetes mellitus (GDM) predicts incident cardiovascular disease (CVD). However, mechanisms linking GDM to CVD beyond intervening incident diabetes are not well understood. We examined the relation of GDM with echocardiographic parameters of left ventricular (LV) structure and function, which are important predictors of future CVD risk. RESEARCH DESIGN AND METHODS We studied 609 women (43% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study who delivered one or more births during followup and had echocardiograms in 1990-1991 (mean age 28.8 years) and 2010- 2011. RESULTS During the 20-year follow-up, 965 births were reported, with GDM developing in 64 women (10.5%). In linear regression models adjusted for sociodemographic factors, BMI, physical activity, parity, smoking, use of oral contraceptives, alcohol intake, family history of coronary heart disease, systolic blood pressure, and lipid levels, women with GDM had impaired longitudinal peak strain (215.0 vs. 215.7%, P = 0.025), circumferential peak strain (214.8 vs. 215.6%, P = 0.028), lateral e9 wave velocity (11.0 vs. 11.8 cm/s, P = 0.012), and septal e9 wave velocity (8.6 vs. 9.3 cm/s, P = 0.015) in 2010-2011 and a greater 20-year increase in LV mass indexed to body surface area (14.3 vs. 6.0 g/m 2, P = 0.006) compared with women with non-GDMpregnancies. Further adjustment for incident type 2 diabetes after pregnancy did not attenuate these associations. CONCLUSIONS Pregnancy complicated by GDM is independently associated with increased LV mass and impaired LV relaxation and systolic function. Implementation of postpartum cardiovascular health interventions in women with a history of GDMmay offer an additional opportunity to reduce future CVD risk.

Original languageEnglish (US)
Pages (from-to)400-407
Number of pages8
JournalDiabetes Care
Volume39
Issue number3
DOIs
StatePublished - Mar 2016
Externally publishedYes

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Gestational Diabetes
Left Ventricular Function
Young Adult
Coronary Vessels
Cardiovascular Diseases
Linear Models
Parturition
Blood Pressure
Pregnancy
Body Surface Area
Oral Contraceptives
Parity
Type 2 Diabetes Mellitus
Postpartum Period
Coronary Disease
Smoking
Alcohols
Exercise
Lipids
Health

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialized Nursing

Cite this

Appiah, D., Schreiner, P. J., Gunderson, E. P., Konety, S. H., Jacobs, D. R., Nwabuo, C. C., ... Gidding, S. S. (2016). Association of gestational diabetes mellitus with left ventricular structure and function: The CARDIA study. Diabetes Care, 39(3), 400-407. https://doi.org/10.2337/dc15-1759

Association of gestational diabetes mellitus with left ventricular structure and function : The CARDIA study. / Appiah, Duke; Schreiner, Pamela J.; Gunderson, Erica P.; Konety, Suma H.; Jacobs, David R.; Nwabuo, Chike C.; Ebong, Imo A.; Whitham, Hilary K.; Goff, David C.; Lima, Joao A.; Ku, Ivy A.; Gidding, Samuel S.

In: Diabetes Care, Vol. 39, No. 3, 03.2016, p. 400-407.

Research output: Contribution to journalArticle

Appiah, D, Schreiner, PJ, Gunderson, EP, Konety, SH, Jacobs, DR, Nwabuo, CC, Ebong, IA, Whitham, HK, Goff, DC, Lima, JA, Ku, IA & Gidding, SS 2016, 'Association of gestational diabetes mellitus with left ventricular structure and function: The CARDIA study', Diabetes Care, vol. 39, no. 3, pp. 400-407. https://doi.org/10.2337/dc15-1759
Appiah D, Schreiner PJ, Gunderson EP, Konety SH, Jacobs DR, Nwabuo CC et al. Association of gestational diabetes mellitus with left ventricular structure and function: The CARDIA study. Diabetes Care. 2016 Mar;39(3):400-407. https://doi.org/10.2337/dc15-1759
Appiah, Duke ; Schreiner, Pamela J. ; Gunderson, Erica P. ; Konety, Suma H. ; Jacobs, David R. ; Nwabuo, Chike C. ; Ebong, Imo A. ; Whitham, Hilary K. ; Goff, David C. ; Lima, Joao A. ; Ku, Ivy A. ; Gidding, Samuel S. / Association of gestational diabetes mellitus with left ventricular structure and function : The CARDIA study. In: Diabetes Care. 2016 ; Vol. 39, No. 3. pp. 400-407.
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abstract = "OBJECTIVE Gestational diabetes mellitus (GDM) predicts incident cardiovascular disease (CVD). However, mechanisms linking GDM to CVD beyond intervening incident diabetes are not well understood. We examined the relation of GDM with echocardiographic parameters of left ventricular (LV) structure and function, which are important predictors of future CVD risk. RESEARCH DESIGN AND METHODS We studied 609 women (43{\%} black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study who delivered one or more births during followup and had echocardiograms in 1990-1991 (mean age 28.8 years) and 2010- 2011. RESULTS During the 20-year follow-up, 965 births were reported, with GDM developing in 64 women (10.5{\%}). In linear regression models adjusted for sociodemographic factors, BMI, physical activity, parity, smoking, use of oral contraceptives, alcohol intake, family history of coronary heart disease, systolic blood pressure, and lipid levels, women with GDM had impaired longitudinal peak strain (215.0 vs. 215.7{\%}, P = 0.025), circumferential peak strain (214.8 vs. 215.6{\%}, P = 0.028), lateral e9 wave velocity (11.0 vs. 11.8 cm/s, P = 0.012), and septal e9 wave velocity (8.6 vs. 9.3 cm/s, P = 0.015) in 2010-2011 and a greater 20-year increase in LV mass indexed to body surface area (14.3 vs. 6.0 g/m 2, P = 0.006) compared with women with non-GDMpregnancies. Further adjustment for incident type 2 diabetes after pregnancy did not attenuate these associations. CONCLUSIONS Pregnancy complicated by GDM is independently associated with increased LV mass and impaired LV relaxation and systolic function. Implementation of postpartum cardiovascular health interventions in women with a history of GDMmay offer an additional opportunity to reduce future CVD risk.",
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AU - Jacobs, David R.

AU - Nwabuo, Chike C.

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N2 - OBJECTIVE Gestational diabetes mellitus (GDM) predicts incident cardiovascular disease (CVD). However, mechanisms linking GDM to CVD beyond intervening incident diabetes are not well understood. We examined the relation of GDM with echocardiographic parameters of left ventricular (LV) structure and function, which are important predictors of future CVD risk. RESEARCH DESIGN AND METHODS We studied 609 women (43% black) from the Coronary Artery Risk Development in Young Adults (CARDIA) study who delivered one or more births during followup and had echocardiograms in 1990-1991 (mean age 28.8 years) and 2010- 2011. RESULTS During the 20-year follow-up, 965 births were reported, with GDM developing in 64 women (10.5%). In linear regression models adjusted for sociodemographic factors, BMI, physical activity, parity, smoking, use of oral contraceptives, alcohol intake, family history of coronary heart disease, systolic blood pressure, and lipid levels, women with GDM had impaired longitudinal peak strain (215.0 vs. 215.7%, P = 0.025), circumferential peak strain (214.8 vs. 215.6%, P = 0.028), lateral e9 wave velocity (11.0 vs. 11.8 cm/s, P = 0.012), and septal e9 wave velocity (8.6 vs. 9.3 cm/s, P = 0.015) in 2010-2011 and a greater 20-year increase in LV mass indexed to body surface area (14.3 vs. 6.0 g/m 2, P = 0.006) compared with women with non-GDMpregnancies. Further adjustment for incident type 2 diabetes after pregnancy did not attenuate these associations. CONCLUSIONS Pregnancy complicated by GDM is independently associated with increased LV mass and impaired LV relaxation and systolic function. Implementation of postpartum cardiovascular health interventions in women with a history of GDMmay offer an additional opportunity to reduce future CVD risk.

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