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Increased epicardial adipose tissue thickness (EATT), a component of body visceral adiposity, has been suggested to increase the likelihood of lifetime cardiovascular disease risk. Women with gestational diabetes mellitus (GDM) have higher risk of developing type 2 diabetes and, consequently, a higher cardiovascular risk. We searched if the patients with GDM have increased EATT, along with its relation to the measures of insulin sensitivity.
96 women with GDM, 69 women with healthy pregnant aged between 19 and 44 years were enrolled. They all underwent physical examination and hormonal and metabolic evaluation, as well as standard echocardiography and EATT. EATT was measured by echocardiography above the free wall of the right ventricle. Age, smoking status and pregestational body mass index (pre-BMI) were obtained. Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) formula. Kruskal-Wallis followed by Bonferroni-corrected post hoc Mann-Whitney U tests were used to analyze the data.
The women with GDM were significantly older than the non-diabetic pregnant women (p=0.001). The HOMA index and basal insulin levels were significantly higher in the GDM group than the non-diabetic group (p <0.0001 and p <0.0001, respectively). GDM subjects had higher EATT (p<0.001) but other echocardiographic parameters were not statistically different.
Thickness of the EAT is increased in patients with GDM in conjunction with insulin resistance. Further studies are needed to clarify the relation of EATT and cardiovascular risk in patients with GDM.
|EATT (mm)||4.7 ± 0,88||3.8 ± 0.88||<0.001|
p<0.05 is statistically significant GDM: Gestational Diabetes Mellitus EATT: Epicardial Adipose Tissue Thickness