Prediction of developing metabolic syndrome after gestational diabetes mellitus

Objective

To determine the predictors of subsequent development of metabolic syndrome (MS) in women with previous gestational diabetes mellitus (GDM).

Design

Controlled clinical study.

Setting

University hospital.

Patient(s)

One hundred sixty-four consecutive women with previous GDM were evaluated after a mean follow-up of 40.54 months from index pregnancy. Sixty-five lean women with negative screening for GDM were included as a control group.

Intervention(s)

None.

Main Outcome Measure(s)

Subjects were evaluated for diagnosis of MS according to criteria of the National Cholesterol Education Program and the International Diabetes Federation. Tests were performed including a 75-g oral glucose tolerance test (OGTT), fasting insulin, lipids, plasma fibrinogen, blood pressure, and body measurements. The homeostasis model assessment score was calculated.

Result(s)

The MS prevalence was higher in women with previous GDM, according to both definitions. Univariate analysis showed that prepregnancy obesity, weight gain during follow-up, and fasting glucose level at the OGTT of the index pregnancy were predictors of developing MS. Multivariate analysis showed that fasting glucose level >100 mg/dL at the OGTT of the index pregnancy was an independent predictor of the MS development.

Conclusion(s)

We suggest that early prediction of women with previous GDM who are at high risk for developing MS is possible, and it is vital to prevent MS-related complications.

Key Words: Gestational diabetes, metabolic syndrome, fasting glucose, obesity, weight gain