Inflammatory markers are associated with the progression of gestational diabetes to metabolic syndrome

Abstract

The progression of gestational diabetes mellitus (GDM) to metabolic syndrome (MetS) is associated with systemic inflammation. The aim of this study was to compare the levels of inflammatory markers in former GDM patients with and without MetS. Medical records were screened retrospectively for patients who were diagnosed with GDM 10 (±2) years ago. Former GDM patients were invited to the hospital for an assessment of their current health status. Of 52 women with former GDM, 27 (52%) had MetS. C-reactive protein (CRP), interleukin-6 and plasminogen activator inhibitor-1 (PAI-1) levels were significantly higher in the MetS group while adiponectin was significantly lower (p < .001, p = .037, p = .002 and p = .013, respectively). There was no significant difference in plasma levels of visfatin and tumour necrosis factor-α. Interleukin-6, CRP, PAI-1 and adiponectin may be used as biomarkers to detect MetS in the pre-clinical phase. With timely diagnosis, early interventions can be implemented. IMPACT STATEMENTWhat is already known on this subject? The progression of 'gestational diabetes mellitus' to 'metabolic syndrome' is associated with systemic inflammation. Up to half of cases with former gestational diabetes mellitus (GDM) eventually progress to metabolic syndrome (MetS).What do the results of this study add? Interleukin-6, C-reactive protein, plasminogen activator inhibitor-1 and adiponectin may be used as biomarkers to detect MetS in the pre-clinical phase.What are the implications of these findings from clinical practice and/or further research? The progression of GDM to MetS is associated with systemic inflammation. Potential therapies should therefore target this inflammatory state. Interleukin-6, C-reactive protein, plasminogen activator inhibitor-1 and adiponectin may be used as biomarkers to detect MetS in the pre-clinical phase. With timely diagnosis, early interventions and lifestyle changes can be implemented to prevent morbidity and mortality associated with full-blown MetS.

Keywords: Interleukin-6; PAI-1; adiponectin; gestational diabetes; metabolic syndrome.